Clinical Efficacy Of PVI Guiding Fluid Therapy In Laparoscopic Intestinal Carcinoma Surgery

Objective:To investigate clinical efficacy of Pleth Variability Index(PVI)guiding fluid therapy in laparoscopic intestinal carcinoma surgery,then theoretical evidence were provided by this study for ehanced post-operative recovery.Methods:40 elective patients accepted laparoscopic intestinal carcinoma surgery were randomly assigned to experimental(S group,n=20)or control(D group,n=20)group.Before operation,all patients were administrated 5-7ml/(kg·h)sodium lactate ringer's injection,?.13.5%was used as PVI thershold value in S group,patients with higher PVI over 5min were administrated 250 ml succinylated gelatin,?.Otherwise,fluid therapy sholud be limited.Mean arterial pressure(MAP),central venous pressure(CVP)and urinary volume were used to guide operative fluid therapy in D group..MAP<65mmHg,CVP<8cmH2O and urinary volume<0.5mL/(kg·h),250 ml succinylated gelatin was rapidly intravenous injected.Otherwise,appriopriate fulid were given.Perioperative demographic information of all patients,operative duration of anaesthesiaand surgery,input and output of fulid,adminsitred drug,haemodynamic parameter.at different times,pre-and post-operative results of arterial blood gas analysis,patients' recorvery status and related complication were recorded.SPSS23.0 was used for comparison between two groups.Results:There were no statistical significance between PVI and control group for demographic information(p>0.05).Comparision between PVI and control group:Operative hemodynamic parameters at different times had no statistical significance,additionally,no difference of variation trendency for two group;preoperative baseline blood gas analysis were comparable,postoperative Lac in S group was lower than D group(p<0.05).Comparisons within group:Change of CVP at S group had statistical significance.;postoperative Lac value were lower than preoperative value(p<0.05).No statistical significance were dound for urinary volume,loss volume of blood,duration of anaesthesiaand surgery,number of patients who was administrated propofol?remifentanil and sevoflurane had no statistical significance(p>0.05).Operative volume of crystoloid solution?totol fulid were lower in S group(p<0.05)and volume of colloidal solution were higher(p<0.05).No statistical significance were found for postoperative inpatient duration and plumonary complication.Futhermore,exhaust and defecation time were shorter and lower incidence of postoperative digestive complication in S group(p<0.05).Conclusion:Fulid therapy guided by PVI can maintain operative steady haemdynamic paramete,decrease total volume of infusion fulid,optimize operative fulid therapy,improve instillation of microcirculation,reduce incidence of postoperative gastrointestinal complication.Fulid therapy guided by PVI was worth to introduce for clinic treatment because of effect for enhanced postoperative recovery.