PEDIATRIC SURGICAL PATIENTS

COMPARISON OF THE EFFECTS OF BALANCED SALT SOLUTION WITH 1% DEXTROSE AND PEAD’S SOLUTION ON BLOOD GLUCOSE AND SODIUM LEVELS INTRA OPERATIVELY

Abstract

Almost all the Pediatric surgeons and most of pediatric anesthetists are adhered
to traditional paed’s solution against recommendations due to fear of hypoglycaemia and not
being aware of hyponatremia. Objective: To compare the effects of balanced salt solution
with1% dextrose and Pead’s solution on blood glucose and sodium levels in pediatric surgical
patients intra operatively. Study Design: Interventional quasi experimental study. Setting:
Department of Anesthesia, Intensive care and pain medicine in Sheikh Zayed Medical College/
Hospital Rahim Yar Khan (Pakistan). Period: December 2014 to February 2015. Methodology:
60 patients were enrolled and divided into equal groups named after their respective iv fluids
i.e.‘Pead’s Solution’ & ‘RLD1’. Patients aged between 1 month and 08 years, without gender
discrimination, with ASA 1,2 , fasted according to ASA guidelines undergoing elective surgical
procedure general anesthesia were included in this study. Blood sampling for levels of serum
sodium and glucose was done pre-operatively and 01 hour post-operatively. Results: In
immediate post-operative period incidence of hyperglycemia was statistically higher in ‘Pead’s
Solution’ group (93.3%;28/30) vs ‘RLD1’ group(10%;3/30) p=0.000. Relative risk was 9.3 in
‘Pead’s Solution’ compared with ‘RLD1’ solution. Hyponatremia was statistically higher in
‘Pead’s Solution’ group (56.6%; 17/30) than in‘RLD1’ group (16.6%;5/30) p=0.001. Relative risk
was 3.4 in ‘Pead’s Solution’ compared with ‘RLD1’ solution. Hypoglycemia and hypernatremia
were not found in any patient in either group. Conclusion: Our results reflected that ‘RLD1’is
a better option than ‘Pead’s Solution’ as it is less likely to cause hyponatremia and doesnot
cause hypoglycemia. However a large number of clinical trials in almost every teaching hospital
are required to convince pediatric surgeons and anesthetists to use evidence based solutions.