| Objective To investigate the effects of goal-directed fluid therapy on tissue oxygen metabolism and rSO2 in elderly patients with spine surgery. Methods From January 2019 to January 2020, 60 casesof patients aged 65 to 80 years old were selected from the Second Hospital of Shanxi Medical University, who were in ASA class II/III. All cases were divided into intervention and control groups by random number table method, 30 cases in each group.Interventiongroup was the goal-directed fluid therapy group, in which stroke volume variation (SVV) and cardiac index (CI) were used as volume index. Control group was the traditional fluid therapy group. At time before anesthesia induction (T1), operation beginning time (T2), 1h after operation was began (T3), the end of surgery (T4), 30min after anesthesia (T5), the arterial and central venous blood were collected for blood gas analysis, the total input, intraoperative crystalline fluid and colloidal fluid dosage, haemorrhage, urine volume, frequency of hypotension, hemoglobin concentration (Hb), lactic acid content (Lac), central venous oxygen saturation (ScvO2), local cerebral oxygen saturation (rSO2) were recorded, and oxygen uptake rate (O2ER) of the two groupswascalculated. The differences between the two groups were compared. Results The crystal fluid input, total input, urine volume and frequency of hypotension in intervention group were significantly lower than those in control group (P<0.05).In interventiongroup,O2ER, Lac were lower, rSO2 and ScvO2 were higher, and the difference was statistically significant (P< 0.05). Conclusions Goal-directed fluid therapy is beneficial to reduce oxygen uptake rate, maintain the balance of oxygen supply and demand in the brain, and improve oxygen metabolism and microcirculation in elderly patients with spine surgery. |
