Paediatric peri-op fluid therapy has been a topic of recent debate. All kinds of opinion and views.
In our place a lot of consultants use only Isolyte - P for practically any kind of surgery. This notion is based on the premise that paeds usually end up being hypoglycaemic. But anaesthesia itself produces hyperglycaemia. Also Iso-P is a hypotonic solution. I prefer to use RL exclusively intra-op. Just want to know what is the practice around the world and what does the current evidence support
regards
jafo
we in our children hospital lahore .Pakistan, also use Ringer lactate as the best fluid during intraoperative surgeries
in case of neonates the indications for intra op dextrose is different.in case of peadiatric patients,
1. for cases like circumscision ,herniotomy- done under sedation combined with caudal,spinal or penile block- there is no stress response .so chances of hypeglycemia is less.we give 5% dextrose for fasting deficits and maintainence
2.children undergoing surgeries on liver-- maintainence dextrose is given along with RL for replacement of losses
3.for other cases under GA we go with RL
paediatric fluid management has always been a topic of debate and we all need to share opinions-------pros and cons
read that in France they are using RL mixed with dextrose
probably like RL (500ml) minus 20 ml plus 20 ml D25
1% DRL
that is what they call it
intial studies have been very encouraging
Thanks jafo for making this forum so educative.we do lot of cleft lip and palate surgery & use isolyte-p till two of our patients had postop hyponatraemia.
Since then we r using ringer lactate.