[Dynamics of indicators of blood inorganic phosphorus during gastrointestinal surgery]

Inorganic phosphorus and the associated potassium, magnesium, and sodium ion levels were measured in the serum and daily urine in the perioperative period in 210 patients of both sexes aged 31-84 years subjected to planned and urgent surgery on the abdominal organs. Control group consisted of 14 patients subjected to planned operations for inguinal hernias. Intraoperative hypophosphatemia was observed in all patients at the beginning, during, and immediately after the operation. The level of serum phosphorus decreased greater (48.1%) during operations performed under local anesthesia than under total anesthesia (by 24.5%) or under total anesthesia combined with epidural analgesia (by 20.4%). After the operation, changes in the serum phosphorus concentration directly depended on the severity of hemostatic disorders: after short operations, the level of serum phosphorus spontaneously normalized within the first 24 h after surgery. After more extensive interventions (resections of the stomach, large intestine, abdominoperineal operations), the decrease of serum phosphorus was 0.3 mmole/liter, on average, and persisted for at least 3-5 days after surgery. The changes were the greatest in patients subjected to urgent operations for ileus and peritonitis. In this group, manifest hypophosphatemia persisted for the entire period of observation, that is, for at least 5 days postoperation, and had to be corrected.