Applicacation of acute hypervolemic hemodilution combined with controlled hypotension with Dexmedetomidine in patients during lumbar surgery

Objective To evaluate the clinical effects of acute hypervolemic hemodilution( AHH) combined with controlled hypotension( CH) on patients undergoing lumbar surgery,observe its blood conservation effect and safety. Methods 90 patients undergoing lumbar surgery were randomly divided into three groups with 30 patients each. Patients in group A were infused with Sodium lactate Ringer's solution( 6 ~ 8) mL / kg. Patients in experimental group( n = 30) B were received Sodium lactate Ringer's solution( 6 ~ 8) mL / kg and 6% HES 20 mL / kg in 30 minutes after anesthesia. Group C( n = 30) were managed in the same way with group B,but induced artery blood pressure in a range of( 65 ~ 75) mmHg by Dexmedetomidine. In each group,when blood loss is greater than 20% of blood volume or Hct is lower than 25%,red cells is as appropriate. The HR,MAP,CVP,blood loss,blood transfusion and the time of operation were recorded. The Hb,Hct,PT,APTT and Fg were measured before of AHH,after AHH and at the end of operation. Results The blood loss in experimental group C were significantly lower compared with its in group A( P 0. 01). The Hct and Hb in experimental group on after AHH and at the end of operation were lower compared with those before AHH. The PT,APTT and Fg were increased in experimental group as compared to that before AHH. No lung edema,heart failure and abnormal bleeding occur in two groups. Conclusion AHH combined with dexmedetomidine controlled hypotension,can enhance the effect and improve microcirculation of blood,and decrease the amount of bleeding or even avoid allogeneic blood transfusion,and have no significant influence on the hemodynamics,coagulation function,heart function,can be safely used in lumbar operation.