The aim this study was to examine to what degree the slow turnover of lactated Ringer's solution during anesthesia and surgery can be prevented by infusing esmolol (a ß1-receptor blocker) or phenylephrine in patients undergoing laparoscopic gynecological surgery performed under intravenous anesthesia.
INTRODUCTION The renal clearance of infused crystalloid fluid is very low during anaesthesia and surgery, but experiments in conscious sheep indicate that the renal fluid clearance might approach a normal rate when the adrenergic balance is modified. METHODS Sixty females (mean age, 32 years) undergoing laparoscopic gynecological surgery were randomized to control group and received only the conventional anesthetic drugs and 20 ml/kg of lactated Ringer's over 30 min. The others were also given an infusion of 50 µg/kg/min of esmolol (beta1-receptor blocker) or 0.01 µg/kg/min of phenylephrine (alpha1-adrenergic agonist) over 3 hours. The distribution and elimination of infused fluid was studied by volume kinetic analysis based on urinary excretion and blood Hgb level.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
60
50 µg/kg/min of the ß1-receptor-blocker esmolol was infused intravenous over 3 hours
0.01 µg/kg/min of the alpha-1-adrenergic receptor agonist phenylephrine
Intravenous Infusion of 10 ml/h lactated Ringer's solution that contained no drug
Department of Anesthesiology, First Affiliated Hospital, College of Medicine, Zhejiang University
Hangzhou, China
Urinary excretion
Urine was collected via an indwelling catheter during 3 hours of surgery
Time frame: 3 hours
Volume kinetics of lactated Ringer´s solution
Volume kinetics was analyzed based on serial analysis of the blood Hgb concentration and the collection of urine. Distribution between a central body and a peripheral body fluid space was then calculated over time.
Time frame: 3 hours
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