Utility of bicarbonated Ringer's solution as an intraoperative fluid during long-term laparotomy

Background : We compared the effects on intraoperative acid-base balance of bicarbonated Ringer (BR) and those of acetated Ringer (AR) solutions as an intraoperative fluid during long-term laparotomy. Methods : Forty patients scheduled for laparotomy expected to take more than 5 hours were divided into two groups according to the type of infused solution, BR or AR. Each solution was intravenously administered at a rate between 8 and 10 ml·kg ^-1·hr ^_1. Arterial blood gases were analyzed before and during surgery. Results : Intraoperative arterial blood HCO ₃ ^- and base excess (BE) significantly decreased in the AR group but not in the BR group. HCO ₃ ^- and BE 2 and 4hrs after the start of surgery and at the end of surgery were significantly higher in the BR group than in the AR group. Conclusions : These results suggest that BR has superior effects on the acid-base balance during long-term laparotomy.