EVALUATION OF METABOLIC PROFILE AND ELECTROLYTE VARIATION USING 0.9% NORMAL SALINE AND RINGER'S LACTATE FOR FLUID REPLACEMENT IN MAJOR ABDOMINAL SURGERIES

Dr. MADHUCHANDA BORAH; Dr. PRATIBHA SAHOO; PROF (DR) AMIO KUMAR DEORI

Volume : IX, Issue : VII, July - 2020

EVALUATION OF METABOLIC PROFILE AND ELECTROLYTE VARIATION USING 0.9% NORMAL SALINE AND RINGER'S LACTATE FOR FLUID REPLACEMENT IN MAJOR ABDOMINAL SURGERIES

Dr. Madhuchanda Borah, Dr. Pratibha Sahoo, Prof Dr Amio Kumar Deori

Abstract :

INTRODUCTION: Perioperative fluid replacement therapy is an universal practice but if done inappropriately may lead to poor postoperative outcome. As 0.9%Normal Saline (NS) and Ringer‘s Lactate(RL) both are used frequently but there is lack of consensus regarding the ideal fluid. Our trial compared both fluids regarding perioperative metabolic and biochemical status along with 24hours urine output. MATERIAL AND METHODS: Prospective randomized trial was done in 120 ASA I&II patients undergoing major abdominal surgery receiving either NS or RL intra–operatively @15ml.kg−1hr−1. ABG analysis done preoperatively, immediate–postoperatively and 24hours post–surgery. Results were analyzed with statistical tests. RESULTS: : NS Group had lower mean pH(7.36±0.03), HCO3¬ (21.98±1.31), BE(–2.77±1.88) with higher levels of Sodium(139.68±3.27) and Chloride(108.48±3.86) mmol/l when compared with RL Group (7.41±0.03, 24.89±1.31, 0.42±1.52, 137.22±2.31 and 102.95±3.33) in the immediate postoperative period. But no significant difference noted after 24 hours. DISCUSSION: Body’s homeostasis deals with large water and solute fluxes without remarkable change in blood chemistry in health but anesthetic agents blunts the normal physiological response to volume depletion, surgical stress etc. Effect of different fluids on these responses are largely unknown. Different trials done earlier showed that RL is superior to NS like our study but we found no difference in 24hr urine output unlike some studies done earlier. CONCLUSION: Ringer’s lactate maintains a more physiological picture of acid–base balance in the intraoperative period but both NS & RL can be safely considered for intraoperative usage in healthy patients