IMPACT OF INTRAOPERATIVE FLUID MANAGEMENT ON POST OPERATIVE COMPLICATIONS IN ORTHOPEDIC PATIENTS OF LOWER LIMB SURGERIES

Abstract

Background:

Maintaining hemodynamic stability and reducing postoperative complications depend heavily on optimal intraoperative fluid management. Both fluid restriction and overload can have detrimental effects on tissue perfusion, wound healing, and rehabilitation following orthopedic lower limb procedures. Recently, Goal-Directed Fluid Therapy (GDFT) has drawn interest due to its customized method of balancing fluid administration based on current physiological data. The purpose of this study was to examine the connection between postoperative problems and intraoperative fluid management techniques in orthopedic patients having lower limb procedures.

Methodology:

Orthopedic surgical patients and perioperative specialists, such as anesthesiologists, surgeons, and technologists, participated in a cross-sectional quantitative study. In order to evaluate fluid strategy (restrictive, liberal, or goal-directed) and surgical outcomes such edema, infection, hypotension, and delayed recovery, data were gathered using a structured questionnaire and postoperative records. SPSS version 26 was used for statistical analysis. The relationship between hydration regimen and complication frequency was examined using spearmans rho, with a significance level of p < 0.05.

Result: 

Spearman's rho correlations research revealed a strong positive link between lower-limb orthopedic patients' satisfaction with intraoperative fluid management and a number of postoperative outcomes. Strong correlations between satisfaction with fluid balance and postoperative swelling (r =.453, p < 0.01), breathing difficulties (r =.715, p < 0.01), delayed mobilization (r =.453, p < 0.01), and wound complications (r =.583, p < 0.01) were found, suggesting that poorer fluid control was linked to a higher incidence of these complications. Additionally, a significant association was seen between the requirement for rehospitalization or additional medical care (r =.715, p < 0.01) and postoperative nausea/vomiting or electrolyte imbalance (r =.705, p < 0.01). The largest correlation was seen for overall postoperative recovery (r =.832, p < 0.01), indicating that fluid management significantly affected the quality of recovery. Furthermore, there was a perfect correlation (r = 1.000, p <.01) between the perception of whether fluid balance affected recovery and the patient's knowledge of fluidrelated consequences. These strong associations support the goal of the study by demonstrating intra-operative fluid management to be important in predicting frequency and seriousness of postoperative problems after orthopaedic lower-limb procedures.

Conclusion: 

The ideal approach to reducing postoperative complications and maximizing patient recovery was found to be goal directed fluid therapy. In order to improve results in orthopedic lower limb procedures, the study is highlighted with regards to the importance of customized, realtime fluid modifications guided by hemodynamic monitoring.