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The change of plasma colloid osmotic pressure and blood coaglulation in percutaneous nephrolithotripsy during anesthesia

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
Issue:
19
DOI:
10.3760/cma.j.issn.1008-6706.2010.19.005
Key Word:
经皮肾镜碎石术;血浆胶体渗透压;血栓弹性描记图;Percutaneous nephrolithotripsy;Plasma colloid osmotic pressure;Thromboelastogram

Abstract: Objective To provide basis of preventing and treating complications by monitoring plasma colloid osmotic pressure and blood clotting function during anesthesia of percutaneous nephrolithotomy (PCNL).Methods 30 patients with upper urinary calculus were equally and randomly divided into two groups according to the different anesthesia method. In General anesthesia group, Midazolam 0. 1 mg/kg、diprivan 1.5mg/kg、Vecuronium bromide 0. 15mg/kg、fentanyl 4μg/kg were used to guide and forane 1 ~ 1.3MAC were used to keep inhalation anesthesia. In lumbar-epidural anesthesia group T12~12 or T12 ~ L1 epidural anesthesia with 0.75% ropivacaine 8 ~ 10 ml and L2~4 lumbar anesthesia with bupivacaine 10mg were used. Plasma colloid osnotic pressure, central venous pressure and TEG were detected at the beginning and at the end of operation and fluid consumption were compared between the two groups. Results There was no obvious difference between the two groups. In both groups ,COP was obviously reduced and CVP was improved after the operation which significantly different with those pre-operation ( all P <0. 01 ). R value reduced significantly(P <0. 05). There were 10 patients complicated with chilling, unconffortability,or anxiety. Conclusion During anesthesia of percutaneous nephrolithotomy, with operation time going on, COP reduced obviously, which increased the risk of heart failure, pulmonary edema, etc. but had no effect on blood clotting.

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