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首页> 外文期刊>British journal of neurosurgery >A dose-response relationship study of hypertonic saline on brain relaxation during supratentorial brain tumour craniotomy
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A dose-response relationship study of hypertonic saline on brain relaxation during supratentorial brain tumour craniotomy

机译：超声良血水对脑袋脑袋脑袋肿瘤开颅肿瘤的剂量 - 反应关系研究

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Background: A prospective, randomized, double-blind study was designed to assess differences in brain relaxation between 2 doses of 3% HS during elective supratentorial brain tumour surgery. Methods: 60 patients undergoing supratentorial craniotomy for tumour resection were enrolled to receive either 3 mL/kg (group L) or 5 mL/kg (group H) of 3% HS administered at skin incision. Brain relaxation was assessed after dura opening on a scale ranging 1-4 (1 = perfectly relaxed, 2 = satisfactorily relaxed, 3 = firm brain, 4 = bulging brain). Hemodynamic variables and laboratory values (blood gases, osmolarity, haematocrit, and lactate) were collected before HS infusion and 30, 120 and 360 min after it. Presence of midline shift, postoperative complications, PCU and hospital stay, and mortality after 30 days were also recorded. Results: There was no difference in brain relaxation, with 2.0 (1.0-3.0) and 2.0 (1.0-2.3) (P = 0.535) for patients in groups L and H, respectively. If adjusted for the presence of midline shift, 50% of patients had adequate brain relaxation scores (grades 1 and 2) in group L and 61% in group H (OR 0.64, CI = 0.16-2.49, P = 0.515). No significant differences in perioperative outcome, mortality and length of PCU and hospital stay were observed. Conclusion: 3 mL/kg of 3% HS result in similar brain relaxation scores as 5 mL/kg in patients undergoing craniotomy for supratentorial brain tumour. This study reveals that both high and low doses of 3% HS may be less effective on intraoperative brain relaxation in patients with midline shift.
机译：背景：旨在评估选修脑肿瘤手术期间2剂3％HS的脑松弛差异的预期，随机的双盲研究。方法：60例接受肿瘤切除术后肿瘤切断术的患者，以在皮肤切口施用3％HS的3ml / kg（L）或5ml / kg（h）的3ml / kg（l）或5ml / kg（h）。在压力大厅开口范围内的脑放松评估脑放松（1 =完全放松，2 =令人满意地放松，3 =坚固的大脑，4 =凸出大脑）。在HS输注和30,120和360分钟之前收集血液动力学变量和实验室值（血气，渗透性，血细胞比容和乳酸）。还记录了中线移位，术后并发症，PCU和住院住院以及30天后的死亡率。结果：L和H组的患者分别对脑松弛没有2.0（1.0-3.0）和2.0（1.0-2.3）（p = 0.535）。如果调整了中线移位的存在，50％的患者在L中具有足够的脑弛豫分数（1和2级），61％（或0.64，CI = 0.16-2.49，P = 0.515）。围手术期结果没有显着差异，PCU和住院住院的死亡率和长度。结论：3％/千克3％HS导致类似的脑松弛分数为5毫升/千克，患者进行了脑肿瘤的患者。本研究表明，高剂量和低剂量的3％HS可能对中线移位患者的术中脑松弛有效。

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