Comparison of Acid-Base and Electrolytes Imbalance in Normal Saline and Bicarbonate 1⁄6 Molar Intravenous Fluid Infusions during Cervical and Lumbar Laminectomy: A Pilot Double-Blinded Clinical Trial


Mohammad Hossein Khosravi 1*, Hamidreza Karimi-Sari 1, Seyed Jalal Madani 2, Fariba Araste Fard 2 1- Students’ Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran. 2- Anesthesiology Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.


Mohammad Hossein Khosravi -

Aim: To evaluate electrolytes and acid-base imbalance in normal saline and molar sodium bicarbonate infusions during surgical laminectomy.

Methods: This double-blind randomized clinical trial was approved by the Ethics Committee of Baqiyatallah University of Medical Sciences with Iranian registry code of clinical trials of IRCT2014061717413N4. Patients who met the inclusion criteria, being 35 to 70 years in age, having ASA physical status class I-II, and candidation for cervical and lumbar laminectomy, were enrolled in the study. The patients were randomized into two groups receiving molar sodium bicarbonate and normal saline intravenous solutions for deficit fluid therapy during the surgery. Hemodynamics, arterial blood gases, and electrolytes levels were measured before and after surgery. Data were compared between the groups by SPSS.

Results: Forty patients with a mean age of 49.92 years were evaluated. There were no significant differences in demographic data between the two groups. The mean surgery duration and blood loss, urine, and infused fluid volumes did not indicate significant differences between the two groups (P>0.05). The mean PCO2 and HCO3 values significantly increased in the bicarbonate group, whereas they decreased significantly in the normal saline group. The mean serum lactate increased significantly in the bicarbonate group while the mean serum Cl- increased significantly in the normal saline group (P<0.05).

Conclusion: The results of this study showed the superiority of molar sodium bicarbonate fluid in controlling acid-base and electrolyte imbalance during surgery, but it should be verified by further studies.