WHO Model Prescribing Information: Drugs Used in Anaesthesia
(1989; 60 pages) [French] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsPremedication
Open this folder and view contentsGeneral anaesthetics and oxygen
Open this folder and view contentsLocal anaesthetics
Open this folder and view contentsNon-opioid analgesics
Open this folder and view contentsOpioid analgesics and antagonists
Open this folder and view contentsMuscle relaxants and cholinesterase inhibitors
Open this folder and view contentsBlood substitutes
Close this folderSolutions for correcting water and electrolyte imbalance
View the documentCompound solution of sodium lactate
View the documentGlucose
View the documentGlucose with sodium chloride
View the documentSodium chloride
View the documentPotassium chloride
Open this folder and view contentsAntacid for use in obstetric practice
View the documentAnaesthesia at the District Hospital
View the documentSelected WHO publications of related interest
View the documentBack cover
 

Compound solution of sodium lactate

Group: intravenous infusion fluid
Injectable isotonic solution

General information

Two solutions are widely available that approximate the composition of extracellular fluid (see table).

Component

Concentration (mmol/litre)

 

I

II

Sodium

131.41

130.00

Potassium

5.37

4.02

Calcium

1.84

1.36

Lactate

28.70

27.60

Chloride

111.70

109.10

Clinical information

Uses

• As an alternative to isotonic saline in the preoperative correction of severe fluid and sodium depletion.

• Replacement of extracellular fluid during surgery.

• Initial restoration of circulatory volume in hypovolaemic shock.

Dosage and administration

Individual fluid requirements must always be determined on the basis of clinical and, whenever possible, electrolyte monitoring. As a general guide in adults:

Preoperative fluid replacement: 500 ml at 50 ml/minute as an alternative to isotonic saline.

Fluid replacement during surgery: 5 ml/minute as an alternative to isotonic saline.

Acute hypovolaemic shock: as an alternative to isotonic saline until vasoconstriction disappears and systolic blood pressure reaches 100 mmHg (13.3 kPa).

Contraindications

• Metabolic alkalosis.

Isotonic sodium chloride solution should be used in preference to compound solution of sodium lactate in patients with:

• hypochloraemic alkalosis due to pyloric stenosis
• respiratory or metabolic alkalosis
• diabetes or severe liver impairment.

Precautions

Solutions should not be used unless they are absolutely clear, and must not be administered through apparatus used for blood transfusion because of the risk of coagulation.

Careful monitoring is required throughout the infusion since intravascular overload can occur, particularly in patients with cardiac insufficiency and whenever large volumes are administered rapidly. In this event the infusion must be slowed or suspended and, if necessary, a rapidly acting diuretic administered (for example furosemide 40 mg i.v.).

Adverse effects

Unduly rapid replacement may lead to pulmonary oedema.

Overdosage

Excessive infusion may result in sodium and water retention. Symptoms of hypernatraemia include restlessness, weakness, thirst, dry swollen tongue, flushing of the skin, pyrexia and tachycardia. Symptoms of water retention range from mild lethargy and disorientation to delirium, coma and convulsions.

Storage

Compound solution of sodium lactate should be stored in sealed containers and should not be allowed to freeze.

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