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[腹部大手术中的电解质平衡。II. 全身麻醉与区域麻醉联合应用与恩氟烷麻醉的观察结果(作者译)]

[Electrolyte balance in major abdominal surgery. II. Observations under combined general and regional anaesthesia versus enflurane anaesthesia (author's transl)].

作者信息

Lühr H G, Finsterer U, Folwaczny H, Scholz G

出版信息

Anaesthesist. 1977 Jun;26(6):307-13.

PMID:883612
Abstract

In 20 patients undergoing selective proximal vagotomy using a combination of methohexitone-nitrous oxide-pancuronium-anesthesia and intercostal block, and in 33 patients undergoing large abdominal surgical procedures under enflurane anesthesia, we found a mean decrease in serum potassium after the start of anesthesia of 0.25 mval/l which was maintained during the time of anaesthesia and operation. In spite of an unchanged potassium balance we noted a reduction in red cell potassium in both groups by about 7 mval/l. Serum sodium decreased by about 6 mval/l and base-excess by a mean of 2 mval/l. In both groups we found a nearly indentical and strong correlation between sodium infused and retained. In conclusion changes of serum potassium, serum sodium, base excess, red cell potassium and of sodium and potassium balance are typical of those occurring during large abdominal surgical procedures and the infusion regimen applied. They are, however, not influenced by the type of anaesthesia.

摘要

在20例采用美索比妥-氧化亚氮-潘库溴铵联合麻醉及肋间神经阻滞进行选择性近端迷走神经切断术的患者,以及33例在安氟醚麻醉下接受大型腹部外科手术的患者中,我们发现麻醉开始后血清钾平均下降0.25毫当量/升,且在麻醉和手术期间保持这一水平。尽管钾平衡未变,但我们注意到两组患者红细胞钾均减少约7毫当量/升。血清钠下降约6毫当量/升,碱剩余平均下降2毫当量/升。在两组中,我们发现输入钠量与潴留钠量之间存在几乎相同且很强的相关性。总之,血清钾、血清钠、碱剩余、红细胞钾以及钠和钾平衡的变化是大型腹部外科手术及所应用的输液方案过程中出现的典型变化。然而,它们不受麻醉类型的影响。

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