Comparison of acid–base and electrolyte imbalances between normal saline and 1.4% sodium bicarbonate intravenous fluids therapy during cervical and lumbar laminectomy



Large amounts of normal saline infused in surgeries can cause hyperchloremic metabolic acidosis.


This study was designed to evaluate electrolyte and acid–base imbalances in the common fluid therapy method (normal saline) and the use of 1.4% sodium bicarbonate with normal saline fluid therapy during surgical laminectomy.

Material and methods

In this double-blind randomized clinical trial patients from 35 to 70 years in age, having American Society of Anesthesiologists physical status class I–II, candidation for cervical and lumbar laminectomy in Baqiyatallah Hospital (Tehran, Iran) in 2015 were enrolled. Patients were randomized into either two groups receiving 1.4% sodium bicarbonate and normal saline intravenous solutions for deficit fluid therapy during the surgery. Hemodynamics, arterial blood gases, and electrolytes levels were measured before and after surgery. Data were compared between the groups by SPSS.

Results and discussion

Forty patients with a mean age of 49.9 ± 12.7 years were evaluated. There were no significant differences in demographic data, mean surgery duration, blood loss, urine output, and infused fluid volumes between the two groups (P > 0.05). The mean PCO2and HCO3 values significantly increased in the bicarbonate group, whereas they decreased significantly in the normal saline group. The mean serum lactate increased significantly in the bicarbonate group while the mean serum Cl? increased significantly in the normal saline group (P < 0.05).


The results of this study showed the superiority of 1.4% sodium bicarbonate fluid in controlling acid–base and electrolyte imbalances during this kind of surgery, but it should be verified by further studies.


  • Crystalloid solutions;
  • Fluid therapy;
  • Laminectomy;
  • Sodium Bicarbonate;
  • Water-electrolyte balance

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