Postoperative Hypophosphataemia

The possible mechanisms of postoperative hypophosphataemia were studied in women undergoing uncomplicated cholecystectomy. Six patients were allocated to each of three groups. Group I received no intravenous fluids, group II received dextrose/saline solution alone and group III received dextrose/saline solution with phosphorus supplementation. The serum concentration of inorganic phosphorus fell in all three groups, the greatest fall being in the group receiving dextrose/saline solution. However, the lowest level reached (0.82 mmol/l) was within the normal range for our laboratory. Concentrations of red blood cell adenosine triphosphate and 2,3-diphosphoglycerate showed similar changes. The operations were not associated with a large catabolic response nor with an increase in urinary phosphorus excretion. The postoperative reduction in serum concentration of inorganic phosphorus appeared to be due mainly to haemodilution. There is no indication for routine phosphorus supplementation following uncomplicated elective surgery.