Lee Ki-Young, Yoo Young-Chul, Cho Jin-Sun, Lee Wootaek, Kim Ji-Young, Kim Myoung-Hwa
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea.
J Clin Med. 2021 Apr 25;10(9):1857. doi: 10.3390/jcm10091857.
Stroke volume variation (SVV) has been used to predict fluid responsiveness; however, it remains unclear whether goal-directed fluid therapy using SVV contributes to bowel function recovery in abdominal surgery. This prospective randomized controlled trial aimed to compare bowel movement recovery in patients undergoing colon resection surgery between groups using traditional or SVV-based methods for intravenous fluid management. We collected data between March 2015 and July 2017. Bowel function recovery was analyzed based on the gas-passing time, sips of water time, and soft diet (SD) time. Finally, we analyzed data from 60 patients. There was no significant between-group difference in the patients' characteristics. Compared with the control group ( = 30), the SVV group ( = 30) had a significantly higher colloid volume and lower crystalloid volume. Moreover, the gas-passing time (77.8 vs. 85.3 h, = 0.034) and SD time (67.6 vs. 85.1 h, < 0.001) were significantly faster in the SVV group than in the control group. Compared with the control group, the SVV group showed significantly lower scores of pain on a numeric rating scale and morphine equivalent doses during post-anesthetic care, at 24 postoperative hours, and at 48 postoperative hours. Our findings suggested that, compared with the control group, the SVV group showed a faster postoperative SD time, reduced acute postoperative pain intensity, and lower rescue analgesics. Therefore, SVV-based optimal fluid management is expected to potentially contribute to postoperative bowel function recovery in patients undergoing colon resection surgery.
每搏输出量变异(SVV)已被用于预测液体反应性;然而,基于SVV的目标导向液体治疗是否有助于腹部手术中肠功能的恢复仍不清楚。这项前瞻性随机对照试验旨在比较采用传统方法或基于SVV的方法进行静脉输液管理的结肠切除手术患者之间的肠道蠕动恢复情况。我们在2015年3月至2017年7月期间收集了数据。基于排气时间、饮水时间和软食(SD)时间对肠功能恢复情况进行分析。最后,我们分析了60例患者的数据。患者特征在组间无显著差异。与对照组(n = 30)相比,SVV组(n = 30)的胶体液量显著更高,晶体液量更低。此外,SVV组的排气时间(77.8 vs. 85.3小时,P = 0.034)和SD时间(67.6 vs. 85.1小时,P < 0.001)明显快于对照组。与对照组相比,SVV组在麻醉后护理期间、术后24小时和术后48小时的数字评分量表疼痛评分和吗啡等效剂量显著更低。我们的研究结果表明,与对照组相比,SVV组术后SD时间更快,术后急性疼痛强度降低,且急救镇痛药使用量更低。因此,基于SVV的优化液体管理有望对结肠切除手术患者的术后肠功能恢复有潜在帮助。