Liberal versus Restrictive Fluid Management in Ambulatory Laparoscopic Gynaecological Surgeries: A Randomized Controlled Trial

Optimal perioperative fluid management is an ongoing challenge in anaesthesia practice. While liberal fluid administration has been traditionally recommended to compensate for preoperative fasting and surgical stress, concerns remain regarding potential fluid overload and delayed recovery. Conversely, restrictive regimens, though widely adopted in major abdominal and thoracic surgeries, may risk inadequate tissue perfusion. The applicability of these findings to short-duration, ambulatory laparoscopic gynaecological procedures remains uncertain.

Day-care surgeries demand rapid recovery, minimal postoperative symptoms, and early discharge. Small studies in minor surgery suggest that intravenous fluid therapy can reduce dizziness, thirst, fatigue, and nausea, thereby improving patient comfort and recovery. However, evidence remains inconsistent, and there are no clear guidelines on the optimal intraoperative fluid regimen for this subset of patients.

This randomized controlled trial aims to compare liberal versus restrictive intraoperative fluid administration in ambulatory laparoscopic gynaecological surgery, focusing on time to discharge readiness and patient-centred recovery outcomes. The study is expected to generate robust evidence that will inform perioperative practice and enhance patient safety, satisfaction, and efficiency of ambulatory care.