Renal Function Test, Urine Output, Lactate Level
Conditions
Keywords
Restrictive hydration,, Dopamine,, Norepinephrine,, Serum lactate,, Standard hydration
Brief summary
This study was designed to assess the effect of adding dopamine infusion in addition to restrictive hydration combined with noradrenaline infusion on intraoperative serum lactate levels as an indicator for tissue hypo perfusion and renal function in comparison to restrictive hydration combined with noradrenaline infusion only and standard hydration during open abdominal surgeries.
Detailed description
One hundred and twenty patients were randomly assigned into three groups (dopamine norepinephrine group, restrictive hydration group and liberal hydration group) undergoing open abdominal procedures (radical cystectomy and hemi colectomy). In Restrictive group (n=40): Ringer's solution was infused at a rate of 1 ml.kg.h-1 until the basic part of the surgery (tumor resection) is completed to be followed by 3 ml.kg.h-1 of Ringer's solution until the end of surgery. Noradrenaline infusion (0.07mcg.kg.min-1) was combined with fluids until the end of surgery. In Liberal group (n=40): the conventional fluid replacement was introduced according to maintenance, deficit for the first 3 hours (hours fasting x body weight) and 3rd space loss (estimated between 8-10 ml.kg.h-1). The outcome to be assessed was serial measurements of serum lactate intraoperatively and immediate postoperatively as an index of tissue perfusion, in addition to blood pressure, heart rate and oxygen saturation.
Interventions
DRUGNorepinephrine, dopamine
drugs to decrease bleeding
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* All patients with American Society of Anesthesiologists (ASA) physical status I or II * Age range from 18-80 years scheduled to either radical cystectomy or hemicolectomy were contained in the study.
Exclusion criteria
* Patients with coagulopathies, * Hepatic dysfunction (prothrombin ratio \<50%), * Renal dysfunction, * Congestive heart failure (New York Heart Association scores ≥3), * Contraindications for epidural analgesia (e.g. patient refusal, local infection or coagulopathy), and peripheral vascular disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in serum lactate level | Before induction of anesthesia and up to 12 hours after. | Serum lactate level in mmol/l |
| Changes in renal function test | Before induction of anesthesia and up to 12 hours after. | Measuring creatinine level |
Countries
Egypt
Outcome results
None listed