title: Ringer's lactate, but not hydroxyethyl starch, prolongs the food intolerance time after major abdominal surgery; an open-labelled clinical trial.
abstract: BACKGROUND
  The infusion of large amounts of Ringer's lactate prolongs the functional gastrointestinal recovery time and increases the number of complications after open abdominal surgery. We performed an open-labelled clinical trial to determine whether hydroxyethyl starch or Ringer's lactate exerts these adverse effects when the surgery is performed by laparoscopy.
  
  
  METHODS
  Eighty-eight patients scheduled for major abdominal cancer surgery (83% by laparoscopy) received a first-line fluid treatment with 9 ml/kg of either 6% hydroxyethyl starch 130/0.4 (Voluven) or Ringer's lactate, just after induction of anaesthesia; this was followed by a second-line infusion with 12 ml/kg of either starch or Ringer's lactate over 1 hour. Further therapy was managed at the discretion of the attending anaesthetist. Outcome data consisted of postoperative gastrointestinal recovery time, complications and length of hospital stay.
  
  
  RESULTS
  The order of the infusions had no impact on the outcome. Both the administration of ≥ 2 L of Ringer's lactate and the development of a surgical complication were associated with a longer time period of paralytic ileus and food intolerance (two-way ANOVA, P < 0.02), but only surgical complications prolonged the length of hospital stay (P < 0.001). The independent effect of Ringer's lactate and complications of food intolerance time amounted to 2 days each. The infusion of ≥ 1 L of hydroxyethyl starch did not adversely affect gastrointestinal recovery.
  
  
  CONCLUSIONS
  Ringer's lactate, but not hydroxyethyl starch, prolonged the gastrointestinal recovery time in patients undergoing laparoscopic cancer surgery. Surgical complications prolonged the hospital stay.
authors.affiliation: Department of Anaesthesia, the first Affiliated Hospital, Zhejiang University, Zhejiang, People's Republic of China. yuh_li@qq.com.|Department of Anaesthesia Shaoxing People's Hospital, Shaoxing, People's Republic of China. yuh_li@qq.com.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Anaesthesia, the first Affiliated Hospital, Zhejiang University, Zhejiang, People's Republic of China. 15347172@qq.com.
authors.forename: Rui
authors.initials: R
authors.lastname: He
authors.affiliation: Department Colorectal Surgery, Shaoxing People's Hospital, Shaoxing, People's Republic of China. 1250700404@qq.com.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Ying
authors.affiliation: Research Unit, Södertälje Hospital, and the Section for Anaesthesia, Linköping University, Linköping, Sweden. r.hahn@telia.com.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hahn
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D004435:Eating / Q000502:physiology; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000009:adverse effects; D007552:Isotonic Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D020127:Recovery of Function / Q000502:physiology; D000077325:Ringer's Lactate; D013997:Time Factors
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077325:Ringer's Lactate