Singhatas Pongsasit, Sangdee Nakkanan, Kositchaiwat Savit, Sumboonanonda Kanit, Suwanthanma Weerapat, Sumritpradit Preeda, Lertsithichai Panuwat
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
J Med Assoc Thai. 2009 Dec;92(12):1616-20.
To determine the effect of oral sodium phosphate solution, as a colon preparation agent, on the serum potassium level in patients undergoing colonoscopy under IV anesthesia.
Patients set to undergo elective colonoscopy under IV anesthesia (propofol infusion) were recruited to participate in the present study during the period between October 2008 and January 2009. All patients had normal serum potassium level prior to colon preparation, and all ingested 90 ml of sodium phosphate solution one day before colonoscopy. Blood samples for post preparation potassium level determination were taken immediately before administering IV propofol. Baseline data including age, gender, diagnosis, indication for colonoscopy, underlying illness, concurrent medications and serum potassium and creatinine levels were recorded The serum potassium levels were compared before and after colon preparation, and potentially important baseline risk factors for low potassium levels after colon preparation were determined.
In 48 patients, there was a 0.57 mmol/L (from 4.11 to 3.54 mmol/L) average reduction in the serum potassium level after colon preparation. There were no significant adverse events during colonoscopy. No significant risk factors were identified on multivariable linear regression analysis.
There was a mild reduction in serum potassium level after colon preparation with oral sodium phosphate solution, which was probably not clinically significant. Prophylactic potassium supplement or routine serum potassium monitoring after oral sodium phosphate colon preparation did not seem to be necessary for this group of patients.
确定口服磷酸钠溶液作为结肠镜检查前肠道准备剂，对静脉麻醉下行结肠镜检查患者血清钾水平的影响。
2008年10月至2009年1月期间，招募计划在静脉麻醉（丙泊酚输注）下接受择期结肠镜检查的患者参与本研究。所有患者在肠道准备前血清钾水平正常，且均在结肠镜检查前一天摄入90毫升磷酸钠溶液。在静脉注射丙泊酚前即刻采集用于测定肠道准备后钾水平的血样。记录包括年龄、性别、诊断、结肠镜检查指征、基础疾病、同时服用的药物以及血清钾和肌酐水平等基线数据。比较肠道准备前后的血清钾水平，并确定肠道准备后低钾水平潜在的重要基线危险因素。
48例患者肠道准备后血清钾水平平均降低0.57毫摩尔/升（从4.11毫摩尔/升降至3.54毫摩尔/升）。结肠镜检查期间未发生显著不良事件。多变量线性回归分析未发现显著危险因素。
口服磷酸钠溶液进行肠道准备后血清钾水平有轻度降低，这可能无临床意义。对于该组患者，口服磷酸钠肠道准备后预防性补钾或常规监测血清钾似乎并无必要。
