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静脉输液预防择期结肠镜检查患者低血压。

Intravenous fluid to prevent hypotension in patients undergoing elective colonoscopy.

作者信息

Leslie K, Tay T, Neo E

机构信息

Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Victoria, Australia.

出版信息

Anaesth Intensive Care. 2006 Jun;34(3):316-21. doi: 10.1177/0310057X0603400314.

Abstract

Colonoscopy may be associated with hypotension during sedation leading to postoperative morbidity. However, no treatment is proven to ameliorate intraoperative hypotension for this procedure. We therefore conducted a randomized trial to determine the effect of intravenous fluid infusion on the incidence of hypotension during sedation for colonoscopy. With institutional approval, 160 patients presenting for elective colonoscopy were randomized to 1.5 ml/kg or 15 ml/kg Hartmann's solution before colonoscopy. All observers were blind to group allocation. The incidence of hypotension during sedation (29% vs 25%; P=0.59) and postoperative morbidity (nausea, vomiting, headache, drowsiness and dizziness) (41% vs 39%; P= 0.75) did not differ between the two groups. Hypotensive patients were older, had a higher baseline systolic blood pressure, and were thirstier after fluid infusion than normotensive patients. This study does not support the use of 15 ml/kg Hartmann's solution to reduce the incidence of hypotension or postoperative morbidity in patients undergoing elective colonoscopy.

摘要

结肠镜检查在镇静过程中可能会导致低血压,进而引发术后并发症。然而,尚无经证实的治疗方法可改善该手术过程中的术中低血压情况。因此,我们进行了一项随机试验,以确定静脉输液对结肠镜检查镇静期间低血压发生率的影响。经机构批准,160例择期行结肠镜检查的患者在结肠镜检查前被随机分为两组,分别输注1.5毫升/千克或15毫升/千克的哈特曼氏溶液。所有观察者均对分组情况不知情。两组在镇静期间的低血压发生率(29%对25%;P = 0.59)和术后并发症(恶心、呕吐、头痛、嗜睡和头晕)发生率(41%对39%;P = 0.75)并无差异。低血压患者比血压正常的患者年龄更大,基线收缩压更高,输液后更口渴。本研究不支持使用15毫升/千克的哈特曼氏溶液来降低择期行结肠镜检查患者的低血压发生率或术后并发症发生率。

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