Holte K, Kehlet H
Department of Surgical Gastroenterology, Hvidovre University Hospital, Denmark.
Acta Anaesthesiol Scand. 2002 Oct;46(9):1089-93. doi: 10.1034/j.1399-6576.2002.460906.x.
Preoperative fasting may lead to a fluid deficit of about 1 litre, which may contribute to perioperative discomfort and morbidity. We therefore examined the association between perioperatively administered fluids aiming to correct dehydration and clinical outcome.
Review of randomized, controlled, clinical trials evaluating clinical outcome, in which fluid versus no fluid was administered pre- or intraoperatively, attempting to correct preoperative fluid deficits. Data were obtained from a Medline search (1966-2001), and references cited in original papers. Seventeen trials met the inclusion criteria.
Based on the amount of fluid administered, we divided the studies into two groups. In nine studies, fluid administration was <1 litre, and in eight studies > or =1 litre of fluid was administered. Administration of low-dose fluid reduced preoperative thirst, but the limited data do not allow conclusions on postoperative outcome such as nausea, vomiting, headache and pain. Administration of > or =1 litre fluid generally reduced postoperative drowsiness and dizziness, while the effects on postoperative nausea, vomiting and thirst has not been clarified.
Fluid administration to compensate preoperative dehydration improves symptoms related to dehydration. Based on the available data, administration of about 1 litre fluid pre- or intraoperatively in patients having fasted for minor surgical procedures seems rational.
术前禁食可能导致约1升的液体缺失，这可能会导致围手术期不适及发病。因此，我们研究了围手术期补液以纠正脱水与临床结局之间的关联。
回顾评估临床结局的随机对照临床试验，此类试验在术前或术中给予液体或不给予液体，试图纠正术前液体缺失。数据来自医学文献数据库检索（1966 - 2001年）以及原始论文中引用的参考文献。17项试验符合纳入标准。
根据补液量，我们将研究分为两组。9项研究中补液量<1升，8项研究中补液量≥1升。给予小剂量补液可减轻术前口渴，但有限的数据无法得出关于术后恶心、呕吐、头痛及疼痛等结局的结论。给予≥1升补液通常可减轻术后嗜睡和头晕，而对术后恶心、呕吐及口渴的影响尚不明确。
补液以补偿术前脱水可改善与脱水相关的症状。根据现有数据，对于接受小手术且已禁食的患者，术前或术中给予约1升补液似乎是合理的。
