Safety of 1.5% glycine irrigation fluid on electrolytes and hemoglobin in shoulder arthroscopy: A prospective cohort study

Introduction: The recent developments in minimally invasive surgeries made enormous effects on using small incisions to access different regions of the human body. In orthopedic surgeries and the use of arthroscopy to visualize specific joints and treat different pathologies have been great achievements yet the safety of such instruments and the use of fluid during these surgeries didn’t negotiate before. This study aims to check the safety of using hypoosmolar fluids during shoulder arthroscopic surgeries concerning amount and duration of surgery. Methods: This is a prospective cohort study that was conducted to evaluate the effect of 1.5% glycine infusion amount in liters during shoulder arthroscopic procedure on serum sodium, potassium, and hemoglobin levels and any other observations of symptoms and signs that might be related to electrolytes imbalance. A sample of 106 patients was evaluated to measure the assigned electrolytes and hemoglobin levels before the procedure and 4 hours and 18 hours after the procedure. Results: According to this study, a sample of 106 patients using a data collection form that organized by the research team the average of serum sodium of all included patients observed a drop after 4 hours and 18 hours of surgery of 3.5 m Eq/L, and 2.7 m Eq/L, respectively. However, after we compare the amounts of glycine fluids and its correlation with changes in the levels of sodium, potassium and hemoglobin there was mild negative serum sodium correlation after 4 hours of surgery (Pearson correlation -0.3, p-value of 0.005) and mild positive correlation with serum potassium levels after 18 hours (Pearson correlation 0.21, p-value 0.031). There was no significant effect of duration of procedures and the changes in serum sodium, potassium and hemoglobin levels between the two assigned groups of patients using T-test for independent samples means.Conclusion: this study has demonstrated that patients undergoing operative shoulder arthroscopy using a nonconductive 1.5% glycine fluid is relatively safe to be used about amount and duration of surgery