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BMC Pediatrics
Published in: BMC Pediatrics 1/2016

Open Access 01-12-2016 | Research article

Hypotonic fluid reduce serum sodium compared to isotonic fluids during anesthesia induction in pediatric patients undergoing maxillofacial surgery-type of infusion affects blood electrolytes and glucose: an observational study

Authors: Kentaro Ouchi, Kazuna Sugiyama

Published in: BMC Pediatrics | Issue 1/2016

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Abstract

Background

Reportedly, administration of hypotonic fluids containing 30.8–74 mEq/L sodium with 5 % glucose may lead to serious hyponatremia or hyperglycemia. In Japan, hypotonic fluids containing 90 mEq/L sodium with 2.6 % glucose are commonly used. We compared blood electrolyte balance and blood glucose concentration with the use of isotonic (140 mEq/L sodium with 1 % glucose) versus hypotonic fluids in pediatric patients.

Methods

We studied 77 children aged 5 months to 2 years who underwent oro-maxillofacial surgery and dental treatment under general anesthesia. Patients were categorized according to the fluids infused (hypotonic or isotonic). Blood samples were obtained from the dorsalis pedis artery between the conclusion of anesthesia induction and commencement of surgery. We compared blood sodium, potassium and glucose concentrations in the two fluid groups during the pre-anesthesia and post-anesthesia-induction periods.

Results

There were no significant differences in pre-anesthesia values between isotonic (n = 35) and hypotonic groups (n = 42). There were significant differences between isotonic and hypotonic groups in post-anesthesia-induction concentrations of sodium (isotonic, 138.7 ± 1.4 mEq/L; hypotonic, 137.5 ± 1.3 mEq/L; p = 0.0003) and glucose (isotonic, 88.0 ± 9.4 mg/dL; hypotonic, 109.9 ± 18.4 mg/dL; p < 0.0001), while potassium concentrations were not significantly different (isotonic, 4.0 ± 0.3 mEq/L; hypotonic, 4.0 ± 0.2 mEq/L; p = 0.6615) between the two groups.

Conclusion

Isotonic solution administration enables avoidance of serum sodium reduction and serum glucose elevation in infants, and may therefore enhance patient safety in comparison with hypotonic solutions.

Trial registration

University Hospital Medical Information Network Clinical Trials Registry (UMIN000014648), registration 25 July 2014.
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Metadata
Title
Hypotonic fluid reduce serum sodium compared to isotonic fluids during anesthesia induction in pediatric patients undergoing maxillofacial surgery-type of infusion affects blood electrolytes and glucose: an observational study
Authors
Kentaro Ouchi
Kazuna Sugiyama
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2016
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-016-0650-6

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