Randomized comparison of oral and intravenous fluid regimens after gallbladder surgery

Numerous studies of post-operative fluid status have utilized sophisticated measurements of electrolyte distribution relating results to clinical practice, The aim of this prospective randomized study was to investigate the response of patients undergoing abdominal surgery of moderate severity to conservative postoperative fluid administration, Forty-five patients undergoing open cholecystectomy were randomized to receive 2.5l of fluid (1l normal saline and 1.5l 5% dextrose), 1l of normal saline, or free oral fluids (groups 1, 2, 3, respectively). Serum and urine osmolality and electrolytes were measured pre-operatively and at 24 and 48h post-operatively. Patients remained in the study irrespective of the urine output, Plasma electrolytes and osmolality remained within normal limits in all three groups despite significant changes in urine electrolyte and osmolality in groups 2 and 3. This normal confirms that a conservative approach to fluid administration has no detrimental effect on hydration in fit patients with uncomplicated surgery.