Korean J Anesthesiol.  2004 Sep;47(3):351-355. 10.4097/kjae.2004.47.3.351.

The Effects of Intravascular Volume Expansion on the Stability of Hemodynamic Responses in Patients undergoing Carotid Endarterectomy

• Lee JJ
• Kim GH
• Kim GS
• Lee BD

• KMID: 2299103
• DOI: http://doi.org/10.4097/kjae.2004.47.3.351

Abstract

BACKGROUND: During carotid endarterectomy, hemodynamic stability is very important to reduce the incidence of cerebral stroke and myocardial infarction. Therefore, we studied the effects of intravascular volume expansion using colloid solution on hemodynamic stability.
METHODS
We studied 22 patients undergoing elective surgery under general anesthesia. Preanesthetic mean arterial blood pressure (MABP) and heart rate (HR) were checked, and the intraoperative target range was taken +/- 20% of these values. Following standardized anesthetic technique including intravenous induction with thiopental sodium and vecuronium, standard intraoperative monitoring and direct arterial blood pressure monitoring were instituted. Patients were randomly assigned to a Hartmann's solution group (group H, n = 11) or a pentastarch group (group P, n = 11). Distinct intraoperative episodes beyond the predetermined target range, and the number of episodes requiring interventional therapy were recorded.
RESULTS
The pentastarch group had a significantly lower incidence of episodes requiring interventional drug therapy during the pre-reperfusion period. No difference was found between out of target incidents in MABP and HR.
CONCLUSIONS
During carotid endarterectomy, the infusion of pentastarch solution reduced drug therapy requirement for hemodynamic stability during pre-reperfusion period only.

Keyword

carotid endrterectomy; hemodynamic stability; intravascular volume; pentastarch

MeSH Terms

Anesthesia, General
Arterial Pressure
Colloids
Drug Therapy
Endarterectomy, Carotid*
Heart Rate
Hemodynamics*
Humans
Hydroxyethyl Starch Derivatives
Incidence
Monitoring, Intraoperative
Myocardial Infarction
Stroke
Thiopental
Vecuronium Bromide
Colloids
Hydroxyethyl Starch Derivatives
Thiopental
Vecuronium Bromide