Protective effects of creatine phosphate pretreatment on circulatory function in prone position in elder patients with general anesthesia / 实用医学杂志

ABSTRACT

Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each)the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.