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Journal of Neurosurgical Sciences 2015 Apr 09

lingua: Inglese

Normal saline versus balanced-salt solution as intravenous fluid therapy during neurosurgery: effects on acid-base balance and electrolytes

Hafizah M., Liu C. Y., Ooi J. S.

Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia


AIM: This prospective, randomized controlled study compared the changes in acid-­base balance and serum electrolytes with the use of intravenous balanced and non-­balanced crystalloid solutions intraoperatively during elective neurosurgery.
METHODS: Thirty consented adult patients who underwent craniotomy were randomly allocated into two groups of 15 patients each. The Non-­Balanced Group received 0.9% normal saline while the Balanced Group received Sterofundin® ISO as the intraoperative fluid for maintenance. Biochemical indices for acid-­base balance and serum electrolytes were analyzed periodically.
RESULTS: In the Non-­Balanced Group, significant changes were noted in the pH, base excess and bicarbonate values over time compared to its respective baseline values (p<0.01). Four patients (27.7%) also developed a pH < 7.35 and five patients (33.3%) developed marked acidosis with base excess < -­4.0 at the end of surgery. Both mean sodium and chloride levels were also significantly higher compared to its baseline values respectively (142.6 ± 2.4 versus 138 ± 2.7 mmol/L, p<0.01 and 105.7 ± 4.1 versus 113.2 ± 3.0 mmol/L (p<0.01).
CONCLUSION: A balanced solution (Sterofundin ® ISO) provided significantly better control over acid-­base balance, sodium and chloride levels when used as intraoperative fluid maintenance and replacement during elective neurosurgery.

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