Comparison of Dextrose Water and Hartmann's Solution in Each Low and High Doses for Adult Ambulatory Anesthesia: Effect on Recovery from Anesthesia / 대한마취과학회지

BACKGROUND: Adequate fluid administration for ambulatory anesthesia has not been widely studied because most patients are healthy and operations are short durations and not invasive. However, long pre-operative nothing per os (NPO) time is known to affect post-operative complications like pain, headache, dizziness, drowsiness, fatigue, nausea, vomiting, thirsty, sore throat, or well-being sensation. And amount of administered fluid or inclusion of dextrose during the operation could exercise great influence on those symptoms. Therefore, we compared four fluid regimens; 5% dextrose water 2 ml/kg (D/W2), 20 ml/kg (D/W20) and Hartmann's solution 2 ml/kg (H/S2), 20 ml/kg (H/S20) regarding to post-operative complications of ambulatory anesthesia. METHODS: One hundred and sixty ambulatory anesthesia patients of ASA 1 or 2 undergoing general anesthesia or monitored anesthesia care were randomly assigned into D/W2, D/W20, H/S2 or H/S20. Each group of patients received 5% dextrose water 2 ml/kg, 20 ml/kg, Hartmann's solution 2 ml/kg, or 20 ml/kg for 30 min, respectively. Complications like pain, headache, dizziness, drowsiness, fatigue, nausea, vomiting, thirsty, sore throat, or well-being sensation of patients were checked with systemized questionnaire check box graded 4 scales at recovery room, at evening and at 24 hours later. RESULTS: H/S20 group was better in nausea, thirsty and well-being sensation. Sixteen percent of patients showed hypoglycemia before anesthesia. Dextrose water resulted transient hyperglycemia and osmotic diuresis. CONCLUSIONS: Large amount of Hartmann's solution was generally better regarding post-operative complications. We should pay attention at peri-operative hypoglycemia for ambulatory anesthesia.

Effects of Hyperosmolar Dextrose Water on Healing of Injured Achilles Tendon in Rats

OBJECTIVE: To assess the effects of intratendinous injection of 12.5% dextrose water on healing of injured Achilles tendon in rat. METHOD: Quantification of hydroxyproline concentration in Achilles tendons of 21 Sprague-Dawley rats was performed to assess the concentration of collagen, and hematoxyline-eosin and immunochemistry staining was performed to analyse histopathology. RESULTS: There was no significant difference in collagen concentration between the three groups (p>0.05). Light microscopic examination showed irregular arrangement of coarse collagen fibers and decreased number of fibroblasts in sham treatment and dextrose injection group and showed more irregular arrangement of coarse collagen fibers in dextrose injection group than in sham treatment group. The immunochemical staining of sham treatment and dextrose injection group showed more increased immunoreactivity for type I and III collagen than control group, but the same as in sham treatment group and dextrose injection group. CONCLUSION: The increase of collagen concentration in injured Achilles tendon of rat treated with hyperosmolar dextrose was not found. This implies that clinical observation of collagen remodelling process may alter biomechanical property other than collagen concentration which should be further investigated.