Abstract: Objective To investigate the effects of phenylephrine combined with restricted infusion on the intraoperative hemodynamics and postoperative complications in patients undergoing total hip arthroplasty. Methods A total of 60 patients hospitalized at our hospital from May 2017 to November 2017 were randomly divided into two groups (n=30): a routine infusion group (group S) and a phenylephrine combined with restricted infusion group (group NR). In group S, the patients were infused by routine methods, including cumulative missing amount, physiological requirement per hour, compensatory expansion, body fluid redistribution, blood loss. In group NR, half of total liquid loss was infused within 60 min after intravenous access was established, while constant infusion rate was then set at 4 ml·kg-1·h-1. For immediate anesthesia induction, intravenous injection of 0.2 μg·kg-1·min-1 phenylephrine were given. An equal volume of 6% hydroxyethyl starch 130/0.4 sodium chloride was injected due to blood loss. The mean arterial pressure (MAP), heart rate, cardiac output (CO), cardiac index (CI), stroke volume (SV) were recorded before anesthesia induction (T0), after anesthesia induction (T1), when the operation began (T2), before cement infusion (T3), immediately when being infused (T4), 3 min after infusion (T5), 10 min after infusion (T6) and the operation ending (T7). Arterial blood samples were collected to test lactic value at T0 and T7. The volume and postoperative complications were recorded. Results Compared with T0, groups S and NR demonstrated significantly reduced heart rate, MAP, CO, CI, and SV at T1-T7 (P<0.05). Compared with group S, group NR produced markedly increases in MAP, CO, CI and SV at T1, T4, and T5 (P<0.05). There were no significant difference in heart rate between groups NR and S (P>0.05). Compared with group S, the total fluid infusion, crystal infusion, and urine volume were lower in group NR (P<0.05). Compared with group S, there were fewer total cases of postoperative hypertension, postoperative nausea, vomiting and postoperative complications in group NR (P<0.05). There was no significant difference in lactate values between the two groups (P>0.05). Conclusions Phenylephrine combined with restricted infusion is safe and effective in maintaining hemodynamic stability and reducing complications.
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