Does Fluid Replacement From Preoperative NPO Status Improve Postoperative Recovery

Not Applicable

Completed

Brief Summary: The investigators are testing the hypothesis that administering 2L of body temperature warmed lactated ringer's intravenously prior to surgery can optimize the postoperative and recovery of patients undergoing total hip and total knee arthroplasty.

Detailed Description: Hip and knee arthroplasty are safe and reliable surgeries for the majority of patients, but a small percentage experience major complications such as myocardial infarction, deep vein thrombosis (DVT), and pulmonary embolism (PE). As these complications are related to local tissue hypoxemia and patient immobility, interventions that can improve the ability of the heart to deliver blood to the tissue and help patients mobilize earlier in their postoperative course may decrease these complications. Based on recent evidence, it has been shown that many patients are dehydrated before surgery, which can make them feel nauseous, tired, and increase their perception of pain making them less likely to mobilize. This predisposes them to DVTs, pulmonary embolism, nausea and vomiting. Peri-operative dehydration can also decrease the ability of the lungs to oxygenate the blood properly and can place additional stress on the heart, which can increase the risk of heart attacks. The specific aim is to determine if patients' peri-operative hemodynamics can be improved with preoperative administration of 2 L of lactated ringers, and consequently reduce postoperative complications and improve recovery in arthroplasty patients.

Recruitment & Eligibility

Inclusion Criteria

All patients >= 18 years of age, undergoing a total primary knee or hip arthroplasty

Exclusion Criteria

Patients weighing less than 80 kg.
Patients undergoing irrigation and debridement, explantation, or revision will not be eligible.
history of kidney disease, congestive heart failure, pulmonary edema, cirrhosis of the liver, or history of systemic fluid overloard will be excluded from the study.
No one will be excluded based on gender, ethnicity or race.

Arm && Interventions

Group	Intervention	Description
Drug Lactated Ringer	Lactated Ringer	Covered two liters of body temperature warmed lactated ringer's in the immediate preoperative setting of subjects undergoing total knee or total hip replacement
Placebo	Placebo	Covered empty bag with no hydration supplement

Primary Outcome Measures

Name	Time	Method
Number of Participants With Postoperative Complications	90 days post surgery	Patients found to have a 90-day postoperative complication categorized as Infection, CHF/Fluid overload, MI, DVT/PE, other

Secondary Outcome Measures

Name	Time	Method
Volume of Fluid Administred	surgical period	milliliters of fluid administered during surgery
90 Day Readmission Count	90 days postop	Patient readmitted to the hospital 90 day postoperatively
Duration of Surgery	Incision to end of surgery	Minutes recorded for length of surgery
Emesis Episodes	Hospital Stay	Number of recorded emesis episodes in the medical record while patient was hospitalized
Duration of Hospital Stay (Hours)	Surgery to hospital discharge	Hours of Hospital Stay