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- Sushama R Tandale, Kalpana V Kelkar, Sunita M Khedkar, and Jayesh R Desale.
- Department of Anaesthesia, B.J. Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
- Saudi J Anaesth. 2019 Jul 1; 13 (3): 197-202.
ContextUnder anesthesia, blood glucose level in term neonates varies widely due to stress induced glucose mobilisation due to various factors. Postoperative hyponatremia occurs with intraoperative infusion of large volume of hypotonic fluid. There is a growing consensus on the intraoperative use of 1-4% glucose containing isotonic fluid in them.AimsTo know the relation of duration of surgery, infusion rate, fluid bolus, blood transfusion with blood glucose level and effect on serum sodium level with intraoperative 1% dextrose ringer's lactate (1% DRL) in neonates undergoing surgery.Settings And DesignProspective single-center study in tertiary institute.Subjects And MethodsA total of 100 neonates undergoing various surgeries under general anesthesia with or without caudal anaesthesia were included. 1% DRL was used as maintenance and replacement fluid intraoperatively. Blood glucose level at hourly interval throughout surgery and serum sodium concentration before and after infusion was documented.Statistical Analysis UsedStudent's t test (two tailed, independent) has been used for statistical analysis.ResultsAfter the infusion of 1% DRL during surgery, mean blood sugar levels were increased above the base line in all neonates at successive hourly interval. Serum sodium levels remained within physiological range in all neonates.ConclusionIntraoperative hyperglycemia is more obvious with higher intravenous fluid infusion rate, prolonged duration of surgery, and requirement of fluid bolus as well as blood transfusion intraoperatively. Use of 1% DRL in neonates undergoing surgery is effective in preventing dysnatremia.
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