Perioperative Fluid Management for Elective Major Surgery Patients at a Teaching Hospital in Rwanda

Abstract

Background

Every year, over 312 million surgical operations are performed globally. While perioperative goal-directed fluid strategy may reduce postoperative complications among patients undergoing major surgery, poor perioperative fluids management has been linked to adverse postoperative patients’ outcome.

Methods

This study used quantitative prospective design to assess the perioperative fluids management in 133 patients operated in the theatre of University Teaching Hospital of Butare (CHUB). The SPSS 21 was used to analyze the data, Chi-square test was performed to assess the association between fluid administered and patients’ hydration status with an acceptable cutoff at p<0.05.

Results

The findings showed that 108 (81.2%) and 25 (18.8%) participants were in dehydration class A and B before surgery and strongly associated with age, surgeries, type and amount of intraoperative fluids. Participants received RL and NS (67.7%), 2091.73 ml, +803.6 ml and lost 218.42+131.9 ml fluid in average. Postoperatively, 53.4% and 46.6% participants were in dehydration class A and B respectively, strongly associated with type and duration of surgery (P<0.05). All participants fasted more than 6 hours.

Conclusion

The dehydration rate increased intraoperatively in relation to type and duration of surgery and type and amount of fluid administered. Reduced fasting time and effective intraoperative fluid management would improve the patients’ hydration after surgery and postoperative patients’ outcome.

Key words: Major Surgery, Elective Surgery, Perioperative care, Fluid management, patients