Studies on the use of Intravenous Fluid (Management ) in the First Week of Post Operative Period of Gastrointestinal Surgery

Fluid and electrolyte management is the critical factor and integral part of the care for surgical patients post operatively, reducing morbidity and mortality. The present aim of the study was to assess the electrolyte level of the patients before and after surgery, prescribing pattern of I.V.Fluids, correlation of their use in maintaining electrolyte and fluid balance and assessing the cost of I.V.Fluids in relation to the total medication cost. The study was prospective observational, approved by Institutional Human Ethics Committee (IHEC). Out of 97 patients involved in the study 58(59.79%) were male and 39(40.2%) female. Among them perforation (52.57%) was highest in incidence. In the study 3 patients were found with altered electrolytes. The most commonly prescribed fluids in perforation cases 35.29% (18/51) were 5%Dextrose, 5%Dextrose 0.9%Normal saline and Ringer Lactate. The recovery in terms of fluid and electrolyte balance was also found to be faster in such patients. An attempt was made to assess the cost of I.V.Fluids (i)Percentage difference in selling price where Ringer Lactate made highest margin (100%), (ii)Pharmacy A,B,C made profit on Ringer Lactate (51.42%), Electrolyte M (138%),5%Dextrose (84.61%) respectively whereas Rajah Muthaih Medical College and Hospital made highest profit from 5%Dextrose,5%Dextrose 0.9%Normal saline(14.28%). (iii) Comparison of cost of different agencies (In Indian Rupees )was done where price ranged from Rs.6.24 to Rs.72.00. This study also found that I.V.Fluids occupied 25.23% of total medication. Apart from maintaining fluid and electrolyte balance in post operative surgical patients, attempt was made to find the pharmacoeconomic use of I.V.Fluids.