الفهرس 
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Abstract
A wide variety of crystalloid solutions are available for intraoperative infusion in major surgery. Normal saline 0.9% is the most common isotonic crystalloid solution used. Although, it is an isotonic solution, it causes hyperchloremic metabolic acidosis, dilutional hypoproteinemia and decrease in anion gap in case of rapid, massive intravenous infusion. Ringer lactate although it slightly hypotonic solution, it tends to lower serum sodium to 130 mEq/L so ringer appear to be the most physiological solution when large volume is necessary, as it converted in liver into bicarbonate. Seventy patients undergoing radical cystectomy & intestinal diversion groups were prospectively randomized into 2 groups. Group I (n=35) received Ringer solution at rate 10 ml kg1 hr1 intraoperatively and 2.5 ml kg1 hr1 postoperatively. Group II (n=35) received Ringer Acetate solution at the same rate of infusion. Arterial blood gases (pH, HCO3, PaCO2), electrolytes (Na+, K+, Ca++) and serum osmolarity were measured preoperatively. The same parameters were measured in the following times: two hours after induction of anesthesia, after posterior dissection of urinary bladder and postoperatively (0 hr., 6hr. and 12 hr). The main results of this study demonstrated that large intravascular volume infusion of Ringer solution causes metabolic acidosis. While Ringer Acetate causes early increase of PaCo2. Both solutions leads to hypocalcaemia but it more significant with Ringer acetate. We conclude that infusion of ringer acetate solution in relatively large volume (10 mL kg1 h1) for prolonged time (B6 hours) was not accompanied by deleterious effect on plasma pH but only transient decrease of osmolarity was recorded. In addition, hypocalcaemia occurred more obviously with RA than R solution.