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Evaluation of the Metabolic Profile of Ringer Lactate versus Ringer Acetate in Nondiabetic Patients Undergoing Major Surgeries
- Source :
- Anesthesia, Essays and Researches
- Publication Year :
- 2018
-
Abstract
- Background: Stress-induced neuroendocrine and metabolic changes lead to intraoperative hyperglycemia which is related to surgery and the type of intravenous fluids used. Aims: The primary objective was to assess the incidence of hyperglycemia with use of lactate versus acetate-based intravenous fluids in nondiabetics undergoing major surgeries. Incidence of lactatemia and metabolic acidosis were also assessed. Settings and Design: Prospective parallel group observational study conducted in a tertiary care institute. Subjects and Methods: A total of 208 nondiabetic patients undergoing major head and neck free flap or abdominal surgeries were included in the study. Group A received Ringer lactate, and Group B received Ringer acetate as intraoperative maintenance fluid. Intraoperative blood sugar, pH, and lactate levels were monitored. Statistical Tests Used: Chi-square test and independent âtâ test were used for analysis. Results: Intraoperative hyperglycemia was more frequent in Group A than B (17.3 vs. 18.4%). Group B patients undergoing gastrointestinal (GI) surgeries showed higher blood glucose at 2, 4, 6, and 8 h when compared to flap surgeries. In Group A, significantly higher blood sugar values were noted at 2 and 8 h in those undergoing GI surgeries. Group B patients undergoing GI surgeries had significantly higher lactate levels at 6 and 8 h. Group B patients had significant acidosis when surgeries lasted >6 h. Conclusion: Nondiabetic patients undergoing major abdominal surgeries who received acetate-based fluids had relatively higher intraoperative blood sugar levels as compared to those receiving lactated solutions, but the incidence of hyperglycemia was comparable. When the duration of surgery exceeded 6 h, acetate-based solutions resulted in significantly higher lactate levels with progressive metabolic acidosis.
- Subjects :
- metabolic acidosis
lactate
business.industry
Acetate
Incidence (epidemiology)
Blood sugar
030208 emergency & critical care medicine
Metabolic acidosis
Free flap
medicine.disease
Group B
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Anesthesia
Materials Chemistry
Medicine
Ringer lactate
Original Article
hyperglycemia
medicine.symptom
business
Metabolic profile
Acidosis
Subjects
Details
- ISSN :
- 02591162
- Volume :
- 12
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Anesthesia, essays and researches
- Accession number :
- edsair.doi.dedup.....3c519b30dc9684fedcade148ac3f338e