Document Detail

A comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery.
MedLine Citation:
PMID:  20185666     Owner:  NLM     Status:  MEDLINE    
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," or "soft" immediately after opening the dura.
RESULTS: Brain 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.
Ching-Tang Wu; Liang-Chih Chen; Chang-Po Kuo; Da-Tong Ju; Cecil O Borel; Chen-Hwan Cherng; Chih-Shung Wong
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  110     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-03-19     Revised Date:  2011-02-14    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  903-7     Citation Subset:  AIM; IM    
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, # 325 Section 2, Chenggung Rd., Neihu 114, Taipei, Taiwan.
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MeSH Terms
Aged, 80 and over
Diuresis / drug effects
Double-Blind Method
Infusions, Intravenous
Intensive Care
Intracranial Pressure / drug effects*
Mannitol / administration & dosage*
Middle Aged
Prospective Studies
Saline Solution, Hypertonic / administration & dosage*
Sodium / blood
Supratentorial Neoplasms / physiopathology,  surgery*
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Saline Solution, Hypertonic; 0/Solutions; 69-65-8/Mannitol; 7440-23-5/Sodium
Comment In:
Anesth Analg. 2011 Feb;112(2):485; author reply 485-6   [PMID:  21257705 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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