Abdominal instillation of high-molecular-weight dextran or lactated Ringer's solution after laparoscopic surgery. A randomized comparison of the effect on weight change.
Abdominal fluid retention after the instillation of lactated Ringer's solution into the abdomen after operative laparoscopy was evaluated by comparing the serial weights of patients receiving lactated Ringer's after surgery to those of patients treated with the abdominal instillation of high-molecular-weight dextran and to those of negative controls. Twenty-four patients were randomized to receive either lactated Ringer's or high-molecular-weight dextran after operative laparoscopy. Patients undergoing only diagnostic laparoscopy served as negative controls. Patients receiving either lactated Ringer's or high-molecular-weight dextran had increased weights as compared to the negative controls for at least 36 hours (P less than .5), although the weight gain in the treatment groups did not differ statistically significantly. The weight gain remained significantly greater than in the negative controls on postoperative days 3 and 4 in patients treated with dextran. Since the "flotation" effect of dextran in preventing pelvic adhesions is likely to be most pronounced in the immediate postoperative period, the findings suggest the need for a reinterpretation of adhesion prevention studies in which the use of dextran was compared to that of lactated Ringer's solution or to saline as a negative control.
Rose
B I
BI
Milton S. Hershey Medical Center, Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey.
MacNeill
C
C
Larrain
R
R
Kopreski
M M
MM
D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D007322:Instillation, Drug; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D008970:Molecular Weight; D000077325:Ringer's Lactate; D013997:Time Factors; D000267:Tissue Adhesions / Q000188:drug therapy / Q000517:prevention & control; D015430:Weight Gain
D003911:Dextrans; D007552:Isotonic Solutions; D000077325:Ringer's Lactate