Comparison Of Three Different Colloid And Crystal Fluids On The Prevention Of TURPS In TUEVP

Objective To investigate the comparison of three different colloid and crystal fluids on prevention of TURPS in short-term TUEVP.Methods 60 patients scheduled for TUEVP, which is controlled within 65 minutes, were randomly divided into three groups:the experimental groupⅠ(6% hydroxyethyl starch 130/0.4,the experimental groupⅡ(4% succinylated gelatin) and the control groupⅢ(lactate Ringer's solution). The preinfusion of the experimental colloids and lactate Ringer's solution is started while the patient is ready for anesthesia, with 10ml/kg in 30 minutes. After preinfusion,0.9% NaCl is used to maintain the volume. MAP, HR, and SpO2 are continously monitored perioperatively. Collect 1ml arterial blood for blood gas analysis at the following times:before anesthesia (T0), bladder irrigation amount of 6000ml (T1), bladder irrigation amount of 12000ml (T2), and before leaving the operating room (T3). Observe the changes of the results from arterial blood gases analysis,blood glucose changes of the three groups at different times, then calculate the crystal osmotic pressure at each time{plasma crystal osmotic pressure=2 ([Na+]+[K+])+glucose, unit:mmol/L}. Recorde the operating time,the volume of infusion fluids and irrigation fluids. Be attention to whether there is TURPS happens:such as apnea, wheezing, cyanosis; even nausea, vomiting, and restlessness.Results:1. Na+:Comparison of intergroups, with the increase of irrigation fluid volume, groupⅠand groupⅡhave no significant changes; compared with T0, groupⅢdecreased significantly at T2 and T3, (p＜0.01, p＜0.01). Comparison between groups, there is no significant differences.2. K+:Comparison of intergroups, with the increase of irrigation fluid volume, there is a decreased trend in all groups, but no statistically significant (p＞0.05). Comparison between groups. there is no significant differences.3. Hb:Comparison of intergroups, compared with T0, all groups were significantly decreased at the T1,T2,T3, group RI is p＜0.05 at T1, other time points p＜0.01; compared with T1, groupⅡand groupⅢhave significant differences at T2 (p＜0.01) and T3 (p＜0.01). Comparison between groups, groupⅠand groupⅢhave significantly differences at T1 (p＜0.01), groupⅡand groupⅢhave significantly differences at T2 (p＜0.01).4. Hct:Comparison of intergroups, compared with T0, groupⅠp＜0.05 at T1, p＜0.01 at T2, T3, groupⅡp＜0.01 at T2, T3, groupⅢp 0.01 at all time points; compared with T1, groupⅠp＜0.01 at T3.5. Blood sugar:Comparison of intergroups, with increases of irrigation fluid volume, all groups have no statistically significant. Comparison between groups, no statistically differences.6. Intravenous fluid volume:groupⅢ＞groupⅠ＞groupⅡ, compared groupⅠwith groupⅢp＜0.05, compared groupⅡwith groupⅢP＜0.05, there is no statistically significant between groupⅠand groupⅡ.7. Adverse reactions:There is no TURPS occurred, and no statistically significant in adverse reactions among the three groups.Conclusions:1. Compared with sodium lactate ringer's injection,6% hydroxyethyl starch,4% gelofusine infusion can decrease the volumn of venous infusion in TUEVP effectively.2. The effects among 6% hydroxyethyl starch,4% gelofusine infusion and sodium lactate ringer's injection on the prevention for TURPS have no significant difference in TUEVP, which use 5% mannitol as the irrigation fluid and be managed within 65 minutes.3. The infusion of these three fluids with 10ml/kg in 30 minutes while anesthesiology can prevent the occurrence of hypotension,bradycardia,hyposodium, etc. effectively.