Медицина неотложных состояний (Jun 2022)

Correction of electrolyte balance in surgical patients during elective surgery

  • P.I. Bignyak,
  • M.L. Homon,
  • K.Yu. Krenyov

DOI
https://doi.org/10.22141/2224-0586.18.4.2022.1499
Journal volume & issue
Vol. 18, no. 4
pp. 38 – 41

Abstract

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Planned surgery is increasingly moving towards ERAS and one-day surgery. Preoperative preparation to planned surgery requires special attention, as any intervention can lead to water-electrolyte imbalance. The aim of the work is to investigate the clinical significance of electrolyte disturbances in planned surgical patients and their correction. Materials and methods. We examined 26 people who were in the control group and received traditional preoperative therapy, 25 patients in the study group who took oral rehydration therapy in the preoperative period, 24 people who received oral rehydration therapy in the postoperative period, and 25 patients who took oral rehydration therapy one day before surgery and in the postoperative period to correct water-electrolyte disorders. To analyze the results of the study, profile analysis was used as a modification of multidimensional covariance analysis with repeated measurements. Results. Normalization of indicators was generally better in all study groups receiving oral rehydration the­rapy in the pre- and/or postoperative period than in patients recei­ving traditional postoperative therapy, but the effect was significant only for a few indicators (including serum potassium and glucose level), which is obviously due to the small sample size. Given the above data, it can be stated that for most homeostasis indicators, normalization in dynamics probably occurred better in groups 1, 2, 3 against the controls. It should be noted that the only reliable mean for rapid normalization of sodium and potassium concentrations in plasma is the prescription of oral rehydration therapy. A negative value of the regression coefficient, in particular for potassium (β = –0.64933), indicates that the best dynamics was observed in this mode (p = 0.045). Conclusions. Oral rehydration therapy is an acceptable alternative to infusion therapy in patients with elective surgeries in the pre- and/or postoperative period. Further research is needed on large samples of patients. If evidence of the benefits of oral rehydration therapy is obtained, it will improve the management of patients in the postoperative period in accordance with the recommendations of ERAS programs and, consequently, improve treatment outcomes.

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