Quick Search:

is currently disabled due to reindexing of the ZORA database. Please use Advanced Search.
uzh logo
Browse by:
bullet
bullet
bullet
bullet

Zurich Open Repository and Archive 

Hübner, M; Schäfer, M; Demartines, N; Müller, S; Maurer, K; Baulig, W; Clavien, P-A; Zalunardo, M P (2012). Impact of Restrictive Intravenous Fluid Replacement and Combined Epidural Analgesia on Perioperative Volume Balance and Renal Function Within a Fast Track Program. Journal of Surgical Research, 173(1):68-74.

Full text not available from this repository.

Abstract

BACKGROUND AND OBJECTIVE: Key factors of Fast Track (FT) programs are fluid restriction and epidural analgesia (EDA). We aimed to challenge the preconception that the combination of fluid restriction and EDA might induce hypotension and renal dysfunction. METHODS: A recent randomized trial (NCT00556790) showed reduced complications after colectomy in FT patients compared with standard care (SC). Patients with an effective EDA were compared with regard to hemodynamics and renal function. RESULTS: 61/76 FT patients and 59/75 patients in the SC group had an effective EDA. Both groups were comparable regarding demographics and surgery-related characteristics. FT patients received significantly less i.v. fluids intraoperatively (1900 mL [range 1100-4100] versus 2900 mL [1600-5900], P < 0.0001) and postoperatively (700 mL [400-1500] versus 2300 mL [1800-3800], P < 0.0001). Intraoperatively, 30 FT compared with 19 SC patients needed colloids or vasopressors, but this was statistically not significant (P = 0.066). Postoperative requirements were low in both groups (3 versus 5 patients; P = 0.487). Pre- and postoperative values for creatinine, hematocrit, sodium, and potassium were similar, and no patient developed renal dysfunction in either group. Only one of 82 patients having an EDA without a bladder catheter had urinary retention. Overall, FT patients had fewer postoperative complications (6 versus 20 patients; P = 0.002) and a shorter median hospital stay (5 [2-30] versus 9 d [6-30]; P< 0.0001) compared with the SC group. CONCLUSIONS: Fluid restriction and EDA in FT programs are not associated with clinically relevant hemodynamic instability or renal dysfunction.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
DDC:610 Medicine & health
Language:English
Date:2012
Deposited On:17 Jan 2011 07:54
Last Modified:27 Nov 2013 20:36
Publisher:Elsevier
ISSN:0022-4804
Publisher DOI:10.1016/j.jss.2010.08.051
PubMed ID:20934714
Citations:Web of Science®. Times Cited: 2
Google Scholar™
Scopus®. Citation Count: 2

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page