Labuschagne G S, Morris R W
Visiting Medical Officer, Department of Anaesthesia, St George Hospital, Sydney, New South Wales.
Head of Department, Department of Anaesthesia, St George Hospital and Clinical Associate Professor, University of New South Wales, Sydney, New South Wales.
Anaesth Intensive Care. 2017 Jul;45(4):485-489. doi: 10.1177/0310057X1704500412.
Sodium picosulfate, used in combination with magnesium oxide and citric acid for bowel cleansing, can result in dehydration. We investigated whether enhanced carbohydrate fluid intake pre-colonoscopy could mitigate this effect. We enrolled 398 elective colonoscopy patients in a prospective, controlled, single-blinded study. The control group (n=194) fasted routinely (minimum seven hours) whilst the treatment group (n=197) drank 1,200 ml carbohydrate solution leading up to admission (up until two hours pre-colonoscopy). On admission a patient survey was completed, and urine specific gravity obtained. Supine blood pressure and pulse rate were measured, and repeated within three minutes of standing. The carbohydrate group had reduced symptoms and signs of dehydration, including thirst (34% versus 65%, <0.001), dry mouth (45% versus 59%, =0.008), dizziness (10% versus 20%, =0.010), lower mean urine specific gravity (1.007 versus 1.017, <0.001), lower incidence of orthostatic hypotension (2.6% versus 11%, <0.001), and lower mean erect pulse rate (78 versus 81 /minute, =0.047). The postural change in systolic blood pressure was less in the treatment group (mean -0.4 mmHg, median -1 mmHg [interquartile range, IQR -7 to 7]) than in the control group (mean -4.1 mmHg, median -1 mmHg [IQR -12 to 3], =0.028). These findings indicate that hydration with carbohydrate solution in patients taking sodium picosulfate has clinical benefit.
匹可硫酸钠与氧化镁和柠檬酸联合用于肠道清洁时，可能会导致脱水。我们研究了结肠镜检查前增加碳水化合物液体摄入量是否可以减轻这种影响。我们进行了一项前瞻性、对照、单盲研究，纳入了398例择期结肠镜检查患者。对照组（n=194）常规禁食（至少7小时），而治疗组（n=197）在入院前（直至结肠镜检查前两小时）饮用1200毫升碳水化合物溶液。入院时完成患者调查，并测量尿比重。测量仰卧位血压和脉搏率，并在站立后三分钟内重复测量。碳水化合物组的脱水症状和体征有所减轻，包括口渴（34%对65%，<0.001）、口干（45%对59%，=0.008）头晕（10%对20%，=0.010）、平均尿比重较低（1.007对1.017，<0.001）、直立性低血压发生率较低（2.6%对11%，<0.001）以及平均直立脉搏率较低（78次/分钟对81次/分钟，=0.047）。治疗组收缩压的体位变化（平均-0.4 mmHg，中位数-1 mmHg [四分位间距，IQR -7至7]）小于对照组（平均-4.1 mmHg，中位数-1 mmHg [IQR -12至3]，=0.028）。这些发现表明，服用匹可硫酸钠患者饮用碳水化合物溶液进行水化具有临床益处。
