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首页> 外文期刊>Anesthesia and Analgesia: Journal of the International Anesthesia Research Society >A comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery.
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A comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery.

机译：3％高渗盐水和甘露醇对择期幕上性脑肿瘤手术患者脑松弛的比较。

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BACKGROUND: In this study, we compared the effects of 3% hypertonic saline (HTS) and 20% mannitol on brain relaxation during supratentorial brain tumor surgery, intensive care unit (ICU) stays, and hospital days. METHODS: This prospective, randomized, and double-blind study included patients who were selected for elective craniotomy for supratentorial brain tumors. Patients received either 160 mL of 3% HTS (HTS group, n = 122) or 150 mL of 20% mannitol infusion (M group, n = 116) for 5 minutes at the start of scalp incision. The PCO(2) in arterial blood was maintained within 35 to 40 mm Hg, arterial blood pressure was controlled within baseline values +/-20%, and positive fluid balance was maintained intraoperatively at a rate of 2 mL/kg/h. Outcome measures included fluid input, urine output, arterial blood gases, serum sodium concentration, ICU stays, and hospital days. Surgeons assessed the condition of the brain as "tight," adequate, relaxation conditions in the HTS group (soft/adequate/tight, n = 58/43/21) were better than those observed in the M group (soft/adequate/tight, n = 39/42/35; P = 0.02). The levels of serum sodium were higher in the HTS group compared with the M group over time (P < 0.001). The average urine output in the M group (707 mL) was higher than it was in the HTS group (596 mL) (P < 0.001). There were no significant differences in fluid input, ICU stays, and hospital days between the 2 groups. CONCLUSIONS: Our results suggest that HTS provided better brain relaxation than did mannitol during elective supratentorial brain tumor surgery, whereas it did not affect ICU stays or hospital days.
机译：背景：在这项研究中，我们比较了3％高渗盐水（HTS）和20％甘露醇对上皮上脑肿瘤手术，重症监护病房（ICU）住院时间和住院天数对脑部松弛的影响。方法：这项前瞻性，随机和双盲研究纳入了因颅骨上脑肿瘤选择开颅手术的患者。患者在头皮切口开始时接受160 mL的3％HTS（HTS组，n = 122）或150 mL的20％甘露醇输液（M组，n = 116），持续5分钟。动脉血中的PCO（2）维持在35至40 mm Hg之内，动脉血压控制在基线值+/- 20％之内，术中以2 mL / kg / h的速度维持正液平衡。结果指标包括输液量，尿量，动脉血气，血清钠浓度，ICU停留时间和住院天数。外科医生将HTS组的大脑状况评估为“紧张”，适当的放松状态（软/足够/紧，n = 58/43/21）比在M组中观察到的情况（软/足够/紧）更好，n = 39/42/35; P = 0.02）。随着时间的推移，HTS组的血清钠水平高于M组（P <0.001）。 M组（707 mL）的平均尿量高于HTS组（596 mL）（P <0.001）。两组之间的输液量，ICU停留时间和住院天数没有显着差异。结论：我们的研究结果表明，在选择性的幕上脑肿瘤手术中，HTS比甘露醇提供了更好的脑部放松，而没有影响ICU的住院时间或住院时间。

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