TheKinetics of Ringer’s Solution in Young and Elderly 在年轻人和老年人的林格氏溶液的动力学.docVIP

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TheKinetics of Ringer’s Solution in Young and Elderly 在年轻人和老年人的林格氏溶液的动力学.doc

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TheKinetics of Ringer’s Solution in Young and Elderly 在年轻人和老年人的林格氏溶液的动力学

The Kinetics of Ringer’s Solution in Young and Elderly Patients During Induction of General and Epidural Anesthesia Yuhong Li, MD, PhD*, Shengmei Zhu, MD, PhD*, Robert G. Hahn, MD, PhD? *Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; and ?Department of Anesthesiology, Karolinska Institute, Stockholm, Sweden Yuhong Li, PhD, MD Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Zhejiang University, 310003 Hangzhou, People’s Republic of China Phone: 86-571Email: yuh_li2002@ Short running head: Kinetics of Ringer’s Solution and Anesthesia ABSTRACT To study whether elderly patients handle infused fluid differently than young ones, the plasma dilution (based on hemoglobin) and volume kinetics of an I.V. infusion of 1000 ml of lactated Ringer’s solution was assessed in 29 patients receiving general anesthesia (15 being 65 yrs of age, and 14 being 65 yrs old) and in 16 receiving epidural anesthesia (7 patients 65 yrs of age and 9 being 65 yrs old). General anesthesia caused the greatest decrease in the arterial pressure (mean 15% versus 9%; P 0.001) and was followed by a more pronounced plasma dilution (30% versus 18%; P 0.001). The induction significantly reduced the distribution rate constant (kt) for the infused fluid, with the lowest values reached during general anesthesia (P0.002). However, two-way ANOVA showed that the patient’s age and the type of anesthesia had no statistically significant influence on the kinetic parameters. We conclude that induction of anesthesia greatly increases fluid-induced hemodilution that can be expressed as a decrease of the distribution rate constant for the infused fluid. The magnitude of this reduction is determined by the associated decrease in arterial pressure and not with the patient’s age or whether general or epidural anesthesia is employed. KEYWORDS Ringer’s solution, volume kinetics, epidural anesthe