Itoh Sohei, Arai Masayasu, Kuroiwa Masayuki, Ando Hisae, Okamoto Hirotsugu
Masui. 2016 Sep;65(8):786-789.
Preoperative dehydration is one of risk factors of hypotension during spinal anesthesia (SA). We hypothesized that preoperative oral rehy- dration (POR) may help prevent hypotension during SA.
After obtaining approval from the ethics committee, patients who underwent surgery twice (urological surgery or orthopedic surgery) within 6 months were enrolled in the study. For the first sur- gery, the patients fasted after midnight and were given an intravenous infusion (100 ml - hr-1) on the morning before the surgery (fasting group). During the second surgery, the patients underwent POR (1,200 ml) from the night prior to the surgery to 2 hr before the surgery (POR group). The same amount of anes- thetic drug was administered during both surgeries. The delta systolic blood pressure (ASBP) was mea- sured between the pre-anesthetic condition and the early phase (0-5 min after SA induction) or secondary phase (10-15 min after SA induction). A P value<0.05 in the t-test was considered to indicate statistical sig- nificance.
The ASBP was lower in the POR group compared to the fasting group during both the early and secondary phases; however, only the ASBP during the early phase was significantly different (P=0.019). There was no difference in the total amount of fluid infusion, heart rate, and levels of anesthesia between both groups during the study.
POR prevented hypotension immedi- ately after SA induction.
术前脱水是脊髓麻醉（SA）期间低血压的危险因素之一。我们假设术前口服补液（POR）可能有助于预防SA期间的低血压。
在获得伦理委员会批准后，纳入6个月内接受两次手术（泌尿外科手术或骨科手术）的患者。第一次手术时，患者午夜后禁食，并在手术前一天上午接受静脉输液（100 ml·小时-1）（禁食组）。第二次手术时，患者在手术前一晚至手术前2小时进行POR（1200 ml）（POR组）。两次手术期间给予相同剂量的麻醉药物。在麻醉前状态与早期阶段（SA诱导后0 - 5分钟）或中期阶段（SA诱导后10 - 15分钟）之间测量收缩压差值（ΔSBP）。t检验中P值<0.05被认为具有统计学意义。
在早期和中期阶段，POR组的ΔSBP均低于禁食组；然而，仅早期阶段的ΔSBP有显著差异（P = 0.019）。研究期间两组之间的输液总量、心率和麻醉水平无差异。
POR可预防SA诱导后立即出现的低血压。
