The effect of hypervolemic hemodilution on blood and coagulation related parameters in elderly patients with combined spinal-epidural anesthesia

Objective To investigate the effect of preoperative acute hypervolemic hemodilution on blood and coagulation related parameters in elderly patients with combined spinal-epidural anesthesia for total hip replacement surgery.Methods Thirty cases of total hip replacement surgery patients were randomly divided into preoperative acute hypervolemic hemodilution group and control group with 15 cases in each group.Arterial blood K+,Na+,Ca2+ and Cl-levels,activated partial thromboplastin time(APTT),prothrombin time(PT) and blood gas were analyzed at the times of before dilution(T0),immediately after dilution(T1),30 minutes after dilution(T2) and the time of operation completion(T3) in dilution group and at the times immediately after anesthesia(T1),30 minutes after anesthesia(T2) and the time of operation completion(T3) in control group.Results The pH at T1,T2 and T3 in dilution group was lower than those at T0(P 0.01) and those at T1,T2 and T3 in control group(P 0.05),while no significant change was found among T1,T2 and T3(P 0.05).There were no significant differences in the level of K+,Na+,Ca2+ and Cl-concentrations,base excess,APTT and PT between the two groups(P 0.05).Conclusion Preoperative acute hypervolemic hemodilution does not show obvious effect on blood and coagulation related parameters in elderly patients with combined spinal-epidural anesthesia.