What may cause acute hyponatremia in the operating room

Administration of hypotonic fluids or absorption of sodium-poor irrigants may result in hyponatremia. Such irrigants are used to facilitate transurethral resection of the prostate or distend the uterus during hysteroscopies. However, isotonic fluids are used increasingly in these settings when bipolar electrical cautery is used for the surgical procedure. Thus hyponatremia as a consequence of these procedures has been observed with decreasing frequency. However, some surgeons may still prefer monopolar cautery because the resection is more rapid. In this instance a hypotonic irrigation fluid is used to prevent dispersal of the electrical current, and in such a scenario hyponatremia is a risk. The most common cause of postoperative hyponatremia is syndrome of inappropriate antidiuretic hormone secretion and subsequent water retention.

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