• Huan-rong Qiu, Shou-yuan Tian, Tie-hu Ye, and Bo Zhu.
• Department of Anesthesiology, Peking Union Medical College Hospital, Beijing 100730, China.
• Zhonghua Yi Xue Za Zhi. 2012 Apr 3; 92 (13): 868-72.

ObjectiveTo audite and compare the perioperative practices of intravenous fluids and electrolyte & glucose monitoring in children undergoing operations for scoliosis in 2008, 2010, prior to and after the publication of guideline in 2009.MethodsRetrospective audit was conducted at Peking Union Medical College Hospital, a tertiary referral teaching hospital in Beijing, China. Children under 14 years old with scoliosis treated surgically in 2008 and 2010 were recruited. The following data were collected from medical files: age, gender, weight, duration of hospitalization, concurrent illness, operation, anesthesia, fluid prescribed during perioperative fasting period, electrolyte monitoring and postoperative pain control, etc.ResultsAmong 235 American Society of Anesthesiologists (ASA) I-II cases, 75 children received dextrose 5% or saline 0.9% during the preoperative fasting period. Intraoperatively, the anesthesiologists preferred dextrose 5% or saline 0.9% in children under 6 years old (n = 15, 2008; n = 15, 2010) and Ringer's solution in those aged 6 - 14 years (n = 84, 2008; n = 94, 2010) and hypotonic fluid was not used. And 82.3% and 94.3% of them received electrolyte examinations preoperatively. The electrolyte results were unavailable postoperatively in 27/122 (in 2008) and 13/113 (in 2010) and serum electrolytes were not assessed before fluid treatment postoperatively. Electrolytes were monitored only once in 82.3% (in 2008) and 70.5% (in 2010) patients. Compared with the preoperative concentration of sodium ion, the mean decrease was approximately 2.0 mmol/L at Day 1 postoperation. Hyponatremia at Day 1 postoperation in 2010 was more common than that in 2008 (26.2% vs 23.6%; P = 0.044). But no significant difference existed between the incidence of hyperglycemia of the same day in 2008 and that in 2010 (P = 0.306).ConclusionCompared with that in 2008, our recent practice of intravenous fluid prescription and electrolyte monitoring is ill-consistent with the recommendations in 2009. Implementation of optimal perioperative fluid management is warranted.

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