الفهرس 
Introduction and Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
The thermic effect of amino acid infusion is augmented under general anesthesia and spinal anesthesia. Mild hypothermia may increase surgical bleeding. The aim of this study is to evaluate the efficacy of preoperative and intra-operative amino acid infusion in reducing hypothermia, shivering, and blood loss in hip surgery under spinal anesthesia.
This study was carried out in EL-Minia University Hospital on fifty patients scheduled for hip surgery under spinal anesthesia. Patients were randomized into two equal groups; (25 patients each): group I (amino acid group, n=25), they received intravenous amino acid infusion (Aminosteril KE 10%, Fresenius Kabi, Germany) at a rate of 2 ml / kg / hr, corresponding to 4 kj of energy / kg / hr, for one hour before spinal anesthesia and for the consecutive two hours during surgery after induction of spinal anesthesia, & group II (control group, n=25), they received intravenous nutrient–free standard saline according to the fluid requirements of the patients without amino acid infusion.
Skin & core body temperature, vasoconstriction threshold, shivering, blood loss & transfusion requirement, mean blood pressure, heart rate, arterial blood gases parameters, preoperative and postoperative hemoglobin concentration, platelet count, prothrombin time, and prothrombin concentration were measured and compared with the control group.
Changes in mean arterial blood pressure, heart rate, and arterial blood gases parameters did not differ significantly between the two groups during the study period. Mean skin temperature at 120 minutes after induction of spinal anesthesia was 32.73 ± 0.35º C in the saline group and 34.86 ± 0.48º C in the amino acid group (p value < 0.05). The core temperature at 120 minutes after induction of anesthesia was 33.67± 0.37 º C in the control group and 36.02 ± 0.21º C in the amino acid infusion group (p value < 0.05). Vasoconstriction threshold occurred in the amino acid infusion group at higher core body temperature (36.1± 0.1 º C) and earlier at 70 ± 5 minutes than that of the control group which occurred at core temperature 34.0 ± 0.1º C at 105± 5 minutes. Blood loss during surgery was significantly larger in the control group (704.88±175.9 ml) than in the amino acid infusion group (553.2±107.14 ml) (p value < 0.05). Also the transfusion requirements were significantly larger in the control group (1779.2±352.9 ml) than in the amino acid infusion group (1398±160.31 ml) (p-value < 0.05).the incidence of shivering was significantly higher in the control group (84%) than in the amino acid infusion group (36%) (p value < 0.05). Platelet counts decreased significantly in both groups (p value < 0.05) immediately and at one day after surgery. There was no statistically significant difference between the two groups as regard coagulation profile. In respect to the side effects, no serious complications reported in both groups throughout the study.