Orbey B C, Alanoglu Z, Yilmaz A A, Erkek B, Ates Y, Ayhan Kuzu M
Department of Anesthesiology and Intensive Care, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey.
Tech Coloproctol. 2009 Mar;13(1):35-40. doi: 10.1007/s10151-009-0456-8. Epub 2009 Mar 14.
This study was undertaken to determine the effect of a restricted versus a standard intravenous fluid regimen on urinary retention and readiness for discharge after surgery for benign anorectal disease.
A total of 41 ASA I-II patients were randomized into a standard fluid regimen group (group S, n=21) or a restricted fluid regimen group (group R, n=20). Spinal anaesthesia was performed with hyperbaric ropivacaine. Haemodynamic variables were noted. Hypotension, headache, analgesia requirement, nausea and vomiting, thirst and urinary retention were evaluated postoperatively. The Mann-Whitney U and chi-squared tests were used.
Patient demographics were comparable between the groups. The area under heart rate versus time curve was higher in group R than in group S (p=0.002). Additional fluid and ephedrine requirements were similar between the groups. First voiding time was longer in group R (p=0.045).
In minor anorectal surgery under spinal anaesthesia with ropivacaine, standard fluid regimen provides stable haemodynamic variables without urinary retention.
本研究旨在确定限制静脉输液方案与标准静脉输液方案对良性肛肠疾病手术后尿潴留及出院准备情况的影响。
总共41例美国麻醉医师协会（ASA）分级为I-II级的患者被随机分为标准输液方案组（S组，n = 21）或限制输液方案组（R组，n = 20）。采用重比重罗哌卡因进行脊髓麻醉。记录血流动力学变量。术后评估低血压、头痛、镇痛需求、恶心和呕吐、口渴及尿潴留情况。使用曼-惠特尼U检验和卡方检验。
两组患者的人口统计学特征具有可比性。R组心率-时间曲线下面积高于S组（p = 0.002）。两组额外的液体和麻黄碱需求量相似。R组首次排尿时间更长（p = 0.045）。
在重比重罗哌卡因脊髓麻醉下进行的小型肛肠手术中，标准输液方案可提供稳定的血流动力学变量且不会导致尿潴留。
