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J R Soc Med 1996;89:249-252
© 1996 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 89, Issue 5 249-252, Copyright © 1996 by Royal Society of Medicine

ORIGINAL ARTICLES

Randomized comparison of oral and intravenous fluid regimens after gallbladder surgery

OC Cassell, N Oakley, AR Forrest, WE Thomas and AR Dennison
Department of Surgery, Royal Hallamshire Hospital, Sheffield, England.

Numerous studies of post-operative fluid status have utilized sophisticated measurements of electrolyte distribution and fluid shift without relating results to clinical practice. The aim of this prospective randomized study was to investigate the response of patients undergoing abdominal surgery of moderate severity to conservative post-operative fluid administration. Forty-five patients undergoing open cholecystectomy were randomized to receive 2.51 of fluid (1 l normal saline and 1.51 5% dextrose), 1 l of normal saline, or free oral fluids (groups 1, 2, 3, respectively). Serum and urine osmolality and electrolytes were measured pre-operatively and at 24 and 48 h post-operatively. Patients remained in the study irrespective of the urine output. Plasma electrolytes and osmolality remained within normal limits in all three groups despite significant changes in urine electrolyte and osmolality in groups 2 and 3. This confirms that a conservative approach to fluid administration has no detrimental effect on hydration in fit patients with uncomplicated surgery.
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