Key result
Intraoperative 130 mEq/L sodium fluids prevent serum sodium drops seen with lower concentrations during anesthesia.
Why the study?
How do different sodium concentrations in intraoperative fluids affect electrolyte and fluid balance in elderly patients under general anesthesia?
RCT (n=21)
No
How do different sodium concentrations in intraoperative fluids affect electrolyte and fluid balance in elderly patients under general anesthesia?
Elderly patients can sufficiently excrete water and sodium intraoperatively, but may require increased potassium infusion to maintain normal serum levels.
May support 130 mEq/l sodium fluids to avoid intraoperative hyponatremia in elderly patients; leaves open potassium repletion strategies.
Three different fluids, were administered in over 70 years old patients operated under general anesthesia. Na concentration in the three different solution was 130mEq/l (H group), 77mEq/l (M group) and 15mEq/l (L group) and the amount of fluid infused was averaged 2500ml within 4 hours. No marked difference in water intake and output balance, was noted between the above groups. Serum Na concentration was decreased in the L and M group but not in the H. Na intake and output balance showed+170mM in the H group in this period which was mostly comparable with +100mM in the M group.Negative balance in K intake and output was noted in the all groups. The above data indicates that elder patient may excrete water and Na sufficiently intraoperative period as well as younger suject does, and in addition suggestes that amount of K infused will be better increased to maintain serum K level normal.
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Takaori et al. (1983) conducted an RCT in Elderly patients undergoing surgery under general anesthesia (n=21). Intraoperative fluid therapy with different Na concentrations vs. Comparison between the three groups was evaluated on Serum Na concentration and Na intake/output balance. In elderly patients under general anesthesia, serum sodium concentration decreased with 15 and 77 mEq/l sodium fluids but not with 130 mEq/l, while all groups showed a negative potassium balance.
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