Application of Goal-directed Fluid Therapy Combined with Low-dose Methoxamine in Combined Radical Thoracoabdominal Surgery for Esophageal Carcinoma

Shan-shan LI; Hui YANG; Zhen-chao LV; Min ZHAO; Guang-shun LIU; Zhong-hui WANG

doi:10.12259/j.issn.2095-610X.S20201105

Volume 41 Issue 11

Dec. 2020

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Shan-shan LI, Hui YANG, Zhen-chao LV, Min ZHAO, Guang-shun LIU, Zhong-hui WANG. Application of Goal-directed Fluid Therapy Combined with Low-dose Methoxamine in Combined Radical Thoracoabdominal Surgery for Esophageal Carcinoma[J]. Journal of Kunming Medical University, 2020, 41(11): 72-77. doi: 10.12259/j.issn.2095-610X.S20201105

Citation:

Shan-shan LI, Hui YANG, Zhen-chao LV, Min ZHAO, Guang-shun LIU, Zhong-hui WANG. Application of Goal-directed Fluid Therapy Combined with Low-dose Methoxamine in Combined Radical Thoracoabdominal Surgery for Esophageal Carcinoma[J]. Journal of Kunming Medical University, 2020, 41(11): 72-77. doi: 10.12259/j.issn.2095-610X.S20201105

Citation:

Shan-shan LI, Hui YANG, Zhen-chao LV, Min ZHAO, Guang-shun LIU, Zhong-hui WANG. Application of Goal-directed Fluid Therapy Combined with Low-dose Methoxamine in Combined Radical Thoracoabdominal Surgery for Esophageal Carcinoma[J]. Journal of Kunming Medical University, 2020, 41(11): 72-77. doi: 10.12259/j.issn.2095-610X.S20201105

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Application of Goal-directed Fluid Therapy Combined with Low-dose Methoxamine in Combined Radical Thoracoabdominal Surgery for Esophageal Carcinoma

doi: 10.12259/j.issn.2095-610X.S20201105

Dept. of Anesthesiology,The 3rd Affiliated Hospital of KunMing Medical University, Kunming Yunnan 650118, China

Received Date: 2020-10-12
Available Online: 2020-12-03
Publish Date: 2020-11-25

Abstract

Abstract

Objective To compare the effects of two fluid management regimens, goal-directed fluid therapy（GDFT）and restrictive fluid therapy, on patients undergoing thoracoabdominal combined endoscopic esophagectomy for esophageal cancer in the context of prophylactic intravenous pump infusion of low-dose methoxamine 1.0～2.5 μg/（kg·min）, in order to provide more optimal fluid management for such patients. Methods Thirty-six patients were scheduled to undergo thoracoabdominal combined with laparoscopic radical esophagectomy foresophageal cancer were divided into goal-directed liquid therapy group（Group G）and restrictive liquid therapy group（Group R）according to random number table method. Group G patients were managed with SVV value of 8%～10%, CI > 2.5 L/（min·m²）as the target. The restrictive infusion regimen was used in group R. HR, MAP, SVV, CO, CI and SV were monitored and recorded before anesthesia induction（T₀）, after anesthesia induction（T₁）, two lung ventilation for 15 min（T₂）, one lung ventilation for 15 min（T₃）, two lung ventilation for 15 min（T₄）after lung recruitment and operation completion（T₅）; intraoperative infusion volume, crystalloid volume, colloid volume, urine volume, blood loss, the usage of methoxamine and the occurrence of early postoperative complications were recorded. Results At the time points of T₄ and T₅, the HR of group G was lower than that of group R, and the difference was statistically significant（P < 0.05）. The MAP, SVV, CO, CI and SV of group G were higher than those of group R, and the difference was statistically significant（P < 0.05）. In terms of fluid intake and output, the total fluid volume in group G was less than that in group R, in which the decrease of crystalloid fluid was the main factor, and the difference was statistically significant（P < 0.05）, while the colloidal fluid volume in group G was more than that in group R, the difference was statistically significant（P < 0.05）; the intraoperative urine volume in group R was significantly more than that in group G, and the difference was statistically significant（P < 0.05）. In terms of complications, the incidence of postoperative nausea and vomiting, cough and expectoration in group G was lower than that in group R. The difference of the pain complications was statistically significant（P < 0.05）. Conclusion GDFT combined with low-dose methoxamine is more suitable for fluid management in patients undergoing thoracoabdominal combined laparoscopic esophagectomy for esophageal cancer.
- Methoxamine,
- Goal-directed fluid therapy,
- Stroke volume variability,
- Early complications

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References(14)

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