The association between intraoperative fluid therapy and postoperative disturbance in sodium and glucose homeostasis in pediatrics undergoing major surgeries / Mina Magdy Shaker Azer ; Supervised Sherry Nabil Naguib , Reham Hussein Saleh , Mai Ahmed Ali

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Background: Perioperative fluid and electrolyte therapy for infants and children can be confusing due the numerous opinions, formulas and clinical applications. Fluid management of the pediatric surgical patient presents challenges to both the anesthesia and surgical teams. The aim of the study was to assess the effects of intraoperative fluids on serum sodium and glucose in pediatrics undergoing major surgery. Methods: A total number of 30 children were divided into two groups; group (A) received Ringer Lactate solution (15 child) and group (B) received Glucose/ Normal Saline solution (15 child). Serum sodium and glucose were analyzed before the induction of anesthesia and immediately after the completion of surgery. Results: There was no evidence of preoperative hyponatremia in either groups. Postoperative serum Na levels were also within normal range for both groups. Postoperative serum glucose levels were elevated in both groups. Postoperative serum glucose level was much more elevated in Group B (glucose/saline) (215.7±45.7) mg/dl explained this by the high glucose concentration in the used solution .Conclusions: As Ringer's lactate did not cause changes in sodium and glucose concentrations, it seems to be the safest for intraoperative use in children undergoing major surgery. As hypotonic fluids may cause hyperglycemia and hyponatremia, they should be avoided intraoperatively

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