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from Section 3 - Practical Use
Published online by Cambridge University Press: 11 April 2024
This chapter considers perioperative fluid therapy in abdominal surgical patients.
A fluid resembling the loss in quantity and electrolyte composition should replace both normal and pathological fluid losses.
Elective surgical patients should eat up to 6 hours and drink up to 2 hours before surgery. Sugar- containing fluids (oral or IV) improve postoperative well-being and muscle strength, and decrease insulin resistance. Length of stay, complications, or mortality is not reduced.
Surgery does not increase the normal fluid and electrolyte losses.
It is not possible to treat a decrease in blood pressure caused by the use of epidural analgesia with fluid.
The goal of <2 liter positive fluid balance is to reduce postoperative complications and risk of death in major abdominal surgery.
A goal of near maximum stroke volume does not provide a better outcome.
In outpatient surgery, 1 liter of IV fluid improves postoperative well-being. The role of glucose-containing fluid in this setting may be beneficial.
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