Department of Anesthesiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, 228, Kanagawa, Japan.
J Anesth. 1996 Sep;10(3):170-5. doi: 10.1007/BF02471385.
We tested hypertonic saline solution (HS) to determine its effectiveness in surgical procedures for prostatic hypertrophy. We randomly selected 40 patients undergoing elective transurethral resection of the prostate for either infusion of HS (3% NaCl) at 4ml·kg(-1)·min(-1) (HS group) or lactated Ringer's solution (LR) at 8 ml·kg(-1)·min(-1) (LR group). Anesthesiologists regulated the intraoperative infusion rate as needed to maintain blood pressure. There were no differences in systolic blood pressure, heart rate, central venous pressure, or arterial blood oxygenation between the two groups. In the HS group, plasma sodium, chloride, and osmolality, measured in the recovery room, were significantly increased; however, they returned to preanesthetic levels the day after surgery. In the LR group, in contrast, plasma sodium decreased significantly and this lower value persisted for 1 day. An osmolar gap exceeding 10mOsm·kg(-1) was observed in 2 patients in the HS group, but plasma sodium remained at normal values. However, in the 1 patient in the LR group whose osmolar gap exceeded 10mOsm·kg(-1), plasma sodium was 115 mEq·I(-1). HS, at a low dose, is useful in the intraoperative management of transurethral resection of the prostate.
我们测试了高渗盐水溶液（HS），以确定其在前列腺肥大手术中的有效性。我们随机选择了 40 名接受经尿道前列腺切除术的患者，他们分别接受 HS（3%NaCl）以 4ml·kg(-1)·min(-1)（HS 组）或乳酸林格氏液（LR）以 8 ml·kg(-1)·min(-1)（LR 组）的输注。麻醉师根据需要调节术中输注速度以维持血压。两组之间的收缩压、心率、中心静脉压或动脉血氧饱和度均无差异。在 HS 组中，在恢复室测量的血浆钠、氯和渗透压明显增加；然而，它们在手术后的第二天恢复到术前水平。相比之下，在 LR 组中，血浆钠显著下降，这种较低的水平持续了 1 天。在 HS 组的 2 名患者中观察到渗透压间隙超过 10mOsm·kg(-1)，但血浆钠仍处于正常值。然而，在 LR 组中，渗透压间隙超过 10mOsm·kg(-1)的 1 名患者的血浆钠为 115 mEq·I(-1)。HS 在低剂量时可用于经尿道前列腺切除术的术中管理。
