A Comparison of the Effect of 0.9% Saline versus Balanced Salt Solution (Plasma Lyte-A) on Acid Base Equilibrium, Serum Osmolarity and Serum Electrolytes in Supratentorial Neurosurgical Procedures Requiring Craniotomy
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 3
Abstract
The most commonly used isoosmolar fluid in neurosurgery is 0.9% saline, which is known to produce hyperchloraemic metabolic acidosis. A balanced salt solution, like PlasmaLyte A, is not only isoosmolar, but also maintains acid –base balance and is stated to produce less serum chloride changes. Our aim was to study the effects of PlasmaLyte-A on acid base balance, serum osmolarity and serum electrolytes in neurosurgical procedures. Methodology: 70 patients posted for elective supratentorial craniotomies were randomly allocated to two groups, to receive either 0.9% saline or PlasmaLyte A as the sole intravenous fluid. Arterial Blood Gas Samples were analysed at regular intervals and the variables noted were: serum osmolarity, pH, base deficit or excess, serum chloride, serum lactate, serum sodium, serum potassium, serum calcium, and glucose levels. Intergroup data was analysed statistically by student’s T test (continuous) and chi-square test (categorical) while repeated ANNOVA and post-hoc Tukey Kramer test was used to analyze data within each group using NCSS statistical software version 9.0. Results: Towards the end of the surgery, pH was found to be low in the normal saline group (7.334±0.05 and 7.275±0.05) as compared to the plasmalyte group (7.402±0.03 and 7.406±0.03), this difference being statistically highly significant (p<0.0001). The difference in base deficit was also highly significant at the same time intervals. Chloride levels were significantly higher in the normal saline group in comparison to the study group at different time intervals (112.8±8.002 and 103.63±6.17) and (115.77±9.84 and 103.15±2.95) (p value<0.0001) while serum electrolytes and serum osmolarity was found to be comparable in both the groups. Conclusion: We conclude that 0.9% saline when used as sole intravenous fluid in neurosurgical procedures, causes significantly higher chloride levels and significant acidosis when compared to plasmalyte A used for the same purpose.
Authors and Affiliations
Abhiruchi Yeshwant Patki
Keywords
Related Articles
- EP ID EP533217
- DOI 10.21088/ijaa.2349.8471.5318.1
- Views 73
- Downloads 0
Comparision of High Dose Rocuronium with Succinylcholine for Intubation
Context: Succinylcholine has extremely rapid onset of action and its shorter duration of action make it the ideal muscle relaxant for rapid sequence intubation. Because of these adverse effects and risks associated with...
Use of Oral Clonidine for Attenuation of Pressor Response of Laryngoscopy and Intubation Associated with IV Ketamine Induction
Background: Premedication is used to provide sedation and anxiolysis and to enhance the quality of induction, maintenance and recovery from anaesthesia. The present study was carried out to study the pressor responses to...
A Comparative Study of Airtraq with Macintosh Laryngoscope for Intubation in Paediatric Population
ontext: Paediatric airway is different than adult airway in terms of anatomy and physiology, therefore techniques and tools for securing the airway are different. Macintosh laryngoscope is most commonly used but, Airtraq...
Fascia Iliaca Compartment Block with Ropivacaine Versus Intravenous Fentanyl in Patients with Fracture Femur
Introduction: Fracture femur, a painful condition is common in the elderly patients with associated co-morbidities. Systemic NSAIDS increase the chances of epigastric pain, coagulation abnormalities where as opioids inc...
Combined Spinal Epidural Anaesthesia versus Spinal Anaesthesia with Clonidine for Hip Surgeries: A Randomized Comparative Study
Background: Surgeries for hip fracture are often time consuming. Both THR and Bipolar surgeries are usually performed under spinal anaesthesia or combined spinal epidural anaesthesia. These surgeries are often accompanie...