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Purpose <p>Patients undergoing surgery are prone to postoperative hyponatremia, which can lead to delirium. However, the optimal sodium concentration for postoperative maintenance fluids in adult patients is still unclear. Therefore, this study examined the incidence of hyponatremia and delirium in postoperative patients.</p> Methods <p>This was a single-center, non-blinded, randomized trial. The inclusion criteria for this study were age 20&#xa0;years or older and elective head and neck cancer or esophageal cancer surgery between April 2018 and June 2023. Patients were randomly assigned to one of three groups based on the sodium concentration in the intravenous fluids administered after surgery: the 140&#xa0;mmol/L sodium (Na<sub>140</sub>) group, the 77&#xa0;mmol/L sodium (Na<sub>77</sub>) group, and the 35&#xa0;mmol/L sodium (Na<sub>35</sub>) group.</p> Results <p>A total of 105 patients had complete data at the end of the study: Na<sub>140</sub> group (n = 35), Na<sub>77</sub> group (n = 32), and Na<sub>35</sub> group (n = 38). The incidence of postoperative hyponatremia was 22.9% (8/35) in the Na<sub>140</sub> group, significantly lower than in the Na<sub>77</sub> group [56.3% (18/32)] and the Na<sub>35</sub> group [60.5% (23/38)] (both p &lt; 0.01). The incidence of postoperative delirium was 20.0% (7/35) in the Na<sub>140</sub> group, 31.3% (10/32) in the Na<sub>77</sub> group, and 23.7% (9/38) in the Na<sub>35</sub> group. No significant difference was observed among the groups (p = 0.56).</p> Conclusion <p>The use of postoperative fluids with a sodium concentration of 140&#xa0;mmol/L significantly reduced the incidence of hyponatremia. There was no significant difference in the incidence of postoperative delirium.</p>

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Incidence of hyponatremia with different postoperative intravenous maintenance fluids: a single-center, prospective, randomized trial

  • 期刊论文

  • 发表日期：

    2025年11月18日

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  • Naotaka Shirakawa,
  • Masahiro Ushio,
  • Nana Furushima,
  • Daichi Fujimoto,
  • Shohei Makino,
  • Yuki Nomura,
  • Norihiko Obata,
  • Satoshi Mizobuchi

摘要

Purpose

Patients undergoing surgery are prone to postoperative hyponatremia, which can lead to delirium. However, the optimal sodium concentration for postoperative maintenance fluids in adult patients is still unclear. Therefore, this study examined the incidence of hyponatremia and delirium in postoperative patients.

Methods

This was a single-center, non-blinded, randomized trial. The inclusion criteria for this study were age 20 years or older and elective head and neck cancer or esophageal cancer surgery between April 2018 and June 2023. Patients were randomly assigned to one of three groups based on the sodium concentration in the intravenous fluids administered after surgery: the 140 mmol/L sodium (Na140) group, the 77 mmol/L sodium (Na77) group, and the 35 mmol/L sodium (Na35) group.

Results

A total of 105 patients had complete data at the end of the study: Na140 group (n = 35), Na77 group (n = 32), and Na35 group (n = 38). The incidence of postoperative hyponatremia was 22.9% (8/35) in the Na140 group, significantly lower than in the Na77 group [56.3% (18/32)] and the Na35 group [60.5% (23/38)] (both p < 0.01). The incidence of postoperative delirium was 20.0% (7/35) in the Na140 group, 31.3% (10/32) in the Na77 group, and 23.7% (9/38) in the Na35 group. No significant difference was observed among the groups (p = 0.56).

Conclusion

The use of postoperative fluids with a sodium concentration of 140 mmol/L significantly reduced the incidence of hyponatremia. There was no significant difference in the incidence of postoperative delirium.