Wet versus dry fluid protocols in adult patients undergoing unilateral orthopedic lower limb surgery under spinal anesthesia

Herdan, Ragaa; Bakri, Mennat-Allah Mahmoud; Abdel-Allah, Essam Sharkawy

doi:10.4103/JCMRP.JCMRP_147_19

Wet versus dry fluid protocols in adult patients undergoing unilateral orthopedic lower limb surgery under spinal anesthesia

Authors

Abstract

Background
Optimal strategy for peri operative fluid therapy remains controversial and uncertain. We compared two different fluid administration protocols (dry/wet) on the hemodynamic variables in adult patients under spinal anesthesia. We hypothesized that both protocols had the same effect.
Patients and methods
A randomized controlled double-blind study was conducted in Assiut University Hospitals and was carried out on 80 adult patients scheduled for unilateral lower limb surgery under intrathecal anesthesia. Group I included 40 patients who were subjected to 'dry' approach of intraoperative 4–6 ml/kg/h of Ringer's lactate starting from conduction of intrathecal anesthesia. Group II included 40 patients who were subjected to 'wet' approach of intraoperative 18–20 ml/kg/h of Ringer's lactate starting from conduction of intrathecal anesthesia.
Results
Both groups are comparable and had no statistically significant differences regarding the demographic data, preoperative investigations, hemodynamic variables, and oxygen saturation. The wet group revealed insignificantly higher intraoperative blood loss. The total intravenous fluid intake was significantly higher in the wet group compared with the dry group (1860±599.77 vs. 716.66±295.75 ml, respectively; P<0.001). No major complications were observed during the whole study period.
Conclusion
The use of the terms 'wet' or 'dry' fluid administration strategies does not precisely define the optimal volume of fluid needed, and continuous monitoring of hemodynamics is essential.

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