Intravenous fluid loading with or without supplementary dextrose does not prevent nausea, vomiting and pain after laparoscopy

Abstract

P Pu ur rp po os se e: : To examine the effects of iv compound sodium lactate (CSL) with and without caloric supplementation with dextrose on nausea, vomiting and pain following general anesthesia for laparoscopy.

Supplemental Intravenous Crystalloid Administration Does Not Reduce the Risk of Surgical Wound Infection

“…However, the incidence of nausea and vomiting during the first 24 hours after surgery was similar in our current treatment groups. This is consistent with other studies in which a benefit of supplemental fluid administration was not apparent (30,31).…”

The Relationship of Intravenous Dextrose Administration During Emergence from Anesthesia to Postoperative Nausea and Vomiting

“…The amount and rate of IV dextrose administration was greater than our patients received, and no comparison was made between baseline and postinfusion blood glucose measurements. In a study of 120 ASA physical status I female patients who did not receive antiemetic prophylaxis, 19 fewer patients developed PONV than we found: 29% in dextrose and 22% in control group patients. Those patients had shorter surgery (mean, 23 minutes) compared with ours (mean, 174 minutes) and received a larger amount of dextrose.…”

“…18 However, there may be an optimal dose of dextrose to obtain this favorable outcome because larger amounts of supplementary IV dextrose do not prevent PONV after outpatient surgery and may increase PONV. 19 We hypothesized that individual differences in blood glucose response, perhaps related to the timing of administration, may contribute to the inconsistent impact of IV dextrose on PONV. It is possible that glucose administration during emergence from anesthesia could impact the incidence of PONV.…”

Are there any benefits from minimizing fasting and optimization of nutrition and fluid management for patients undergoing day surgery?

“…Similar findings were recently reported in patients undergoing knee arthroplasty [26]. In contrast, another study examining gynaecologic surgery [27] failed to show any difference between administration of 1 l fluid and no intravenous fluid. There are no comprehensive data currently available on using different types of fluid, nor have any differences been reported in the incidence of urinary retention or renal function using different protocols [22 ].…”