Trial reportInternational journal of medical sciences2026
An Exploratory Randomized Controlled Trial of 0.9% Saline Versus Lactated Ringer's Solution on Intraoperative Metabolism Among Patients Undergoing Lumbar Spinal Surgery.
Trial report in International journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Intravenous crystalloid fluid infusion is a mandatory nutritional intervention received by surgical patients. Crystalloids vary in the pH value and electrolyte balance when administered; these effects directly alter plasma and urine compositions and can considerably affect the patient's intraoperative metabolism. Methods: This randomized controlled study compared 0.9% saline solution and lactated Ringer's solution in terms of intraoperative metabolism among 56 patients undergoing lumbar spinal surgery. Blood and urine samples were obtained before and after surgery for arterial blood gas analysis and untargeted metabolomic analysis using liquid chromatography-mass spectrometry. Results: Patients receiving 0.9% saline developed hyperchloremic acidosis and exhibited higher postoperative plasma concentrations of sodium (interaction P = 0.008) and glucose (interaction P = 0.034). They also required higher intraoperative norepinephrine doses (18 [0-43] μg vs. 0 [0-5] μg; P < 0.001) compared with patients who received lactated Ringer's solution. Significant intraoperative changes were noted in 27 plasma metabolites and 32 urinary metabolites related to stress responses and catabolic pathways. Patients receiving lactated Ringer's solution exhibited favorable metabolism in the blood. This was indicated by attenuated cortisol concentrations (interaction Conclusions: The administration of lactated Ringer's solution may facilitate more favorable intraoperative metabolic profiles than the administration of 0.9% saline solution during lumbar spinal surgery.
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