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Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients

  • Authors:
    • Yuhong Li
    • Yue Shan
    • Xuezheng Lin
  • View Affiliations / Copyright

    Affiliations: Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing, Zhejiang 312000, P.R. China, Department of Anesthesiology, Taizhou Central Hospital, Taizhou, Zhejiang 318000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 110-116
    |
    Published online on: November 20, 2015
       https://doi.org/10.3892/etm.2015.2886
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Abstract

Preoperative acute hypervolemic hemodilution (AHHD) is a technique used in anesthesia to reduce the number of blood cells lost during intraoperative bleeding. The aim of the present study was to evaluate the effect of the hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints. A total of 20 patients undergoing AHHD following epidural anesthesia were studied, and 20 patients who did not receive hemodilution were used as a control group. All patients were American Society of Anesthesiologists grade I, aged 20‑40 years and undergoing hip arthroplasty surgery. In the AHHD group, 10 ml/kg lactated Ringer's solution was infused over 20 min at the same time as the epidural test dose. The infusion was followed by the infusion of 6% hydroxyethyl starch 130/0.4 over 30 min. Patients in the control group received 10 ml/kg Ringer's solution over 50 min. Propofol was then delivered by a Diprifusor target‑controlled infusion. The predicted blood and effect‑site propofol concentrations were recorded at loss of consciousness (LOC) and return of consciousness (ROC). Probit analysis was used to estimate the values for predicted blood and effect‑site concentrations at the two clinical endpoints. The results showed that the potency of propofol was decreased during AHHD. Compared with the controls, the predicted blood and effect‑site concentrations of propofol at LOC were higher in patients of the hemodilution group, resulting in higher EC50 values (P=0.001 and 0.025, respectively). At ROC, the effect‑site EC50 was 2.9 µg/ml [95% confidence interval (CI), 2.8‑3.0] in hemodilution patients and 2.5 µg/ml (95% CI, 2.2‑2.6) in control patients (P=0.001). With AHHD, the LOC time was significantly longer and the propofol dose was higher, while ROC times were comparable. In conclusion, AHHD increases the requirement for propofol at LOC and prolongs LOC time. Patients with AHHD recovered consciousness at higher effect‑site concentrations of propofol. Thus, the induction dose of propofol should be increased during AHHD.
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Copy and paste a formatted citation
Spandidos Publications style
Li Y, Shan Y and Lin X: Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients. Exp Ther Med 11: 110-116, 2016.
APA
Li, Y., Shan, Y., & Lin, X. (2016). Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients. Experimental and Therapeutic Medicine, 11, 110-116. https://doi.org/10.3892/etm.2015.2886
MLA
Li, Y., Shan, Y., Lin, X."Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients". Experimental and Therapeutic Medicine 11.1 (2016): 110-116.
Chicago
Li, Y., Shan, Y., Lin, X."Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients". Experimental and Therapeutic Medicine 11, no. 1 (2016): 110-116. https://doi.org/10.3892/etm.2015.2886
Copy and paste a formatted citation
x
Spandidos Publications style
Li Y, Shan Y and Lin X: Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients. Exp Ther Med 11: 110-116, 2016.
APA
Li, Y., Shan, Y., & Lin, X. (2016). Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients. Experimental and Therapeutic Medicine, 11, 110-116. https://doi.org/10.3892/etm.2015.2886
MLA
Li, Y., Shan, Y., Lin, X."Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients". Experimental and Therapeutic Medicine 11.1 (2016): 110-116.
Chicago
Li, Y., Shan, Y., Lin, X."Effect of acute hypervolemic hemodilution of 6% hydroxyethyl starch 130/0.4 on the EC50 of propofol at two clinical endpoints in patients". Experimental and Therapeutic Medicine 11, no. 1 (2016): 110-116. https://doi.org/10.3892/etm.2015.2886
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