Comparative study of ringer lactate and balanced salt solution on acid base and electrolyte status in emergency laparotomy

Our study include total 60 patients of intestinal obstruction and perforation undergoing emergency exploratory laparotomy. After Ethical approval, Written informed consent from each patient or his relative will be taken before the procedure.

Inclusion Criteria:

1.     Age group between 18 and 60 years.

2.  Patient received from emergency of SSH within 24hr of admission after resuscitation.

Exclusion criteria

1.  Patient/relative refusal.

2. Patient on high inotropic support.

3.  Patient with any systemic illness like Diabetes, Hypertension etc.

4.  Patient with end stage organ damage e.g. hepatic, renal or cardiovascular disorder.

5.  Patients with abdominal trauma.

The patients will be divided randomly using computer generated number and concealed using sequentially numbered, sealed opaque envelope technique into two equal groups (each 30 patients).

Group R: Will receive Ringer Lactate as intraoperative maintenance fluid.

Group B: Will receive Balanced Salt Solution as intraoperative maintenance fluid up to 6 hours postoperatively.

Patient received in emergency department will be managed and resuscitated as per protocol for management of intestinal obstruction/perforation. Baseline investigations including arterial blood gas (ABG) analysis will be sent. Written informed consent will be taken from all patients before surgical intervention. Those patients will be enrolled in our study who meet the inclusion criteria. Demographic profile and baseline parameters will be recorded. Laparotomy will be done under general anaesthesia with epidural catheter in place for post op analgesia. ABG will be repeated immediately after extubation and 6 hour’s postoperatively. pH, base excess, serum bicarbonate, sodium, potassium, chloride, lactate and serum osmolality will be recorded and compared between two groups.