Hyponatremia in Postoperative Patients

Abstract

Object: This study was done to evaluate the adverse effect of hyponatremia in post-operative patients, the clinical spectrum of complications and comparative study of these complications between the elderly patients (age > 50 years) and relatively young patients (age <50 years). Methods: The present’s study of clinical co-relation of hyponatremia in post-operative patients was carried out in 60 patients. The patients were taken from Department of Surgery. Patients were randomly selected and divided into two groups on the basis of age. Group 1, <50 years of age and group 2, >50 years of age. All selected patients were asked for detailed history of illness and a complete physical and systemic examination was done. All baseline and other relevant investigation were done for confirmation of diagnosis and as pre-operative work up. Serum sodium and potassium was checked in all patients pre-operatively and only serum sodium was checked 24 hours and 48 hours post-operatively. Results: Significant number of patients post operatively developed hyponatremia (30%) and complications (30%) related to hyponatremia ranging from headache, nausea to altered sensorium. (p<0.05, statistically significant). The number of patients who developed post-operative hyponatremia as well as complications of hyponatremia was observed more in the patients who were more than 50 years of age (39.3%). Post-operative hyponatremia and related complications was observed more in patients who were having abdominal pathology like peritonitis and abdominal trauma, (33.3%) which was not statistically significant. Patients who were operated under general anesthesia (72.2%) developed more hyponatremia as compared to patients who were operated under local anesthesia or regional anesthesia (27.8%), which was statistically significant. Conclusion: We conclude that post- operative hyponatremia is not an uncommon post-operative complication and its progression to severe neurological manifestations like seizures, coma and eventual death can be prevented by anticipating hyponatremia in high risk patients, not confusing early manifestations with normal post-operative sequelae and treating hyponatremia as earlier as its symptoms appear.