Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Background: Neurosurgical operations are characterized by major fluid shift, frequent use of diuretics, and prolonged operative time. All these factors make fluid management in these procedures complex and challenging. Evidence on an optimum protocol for intraoperative fluid management in neurosurgical patients is still lacking. The aim is to compare PPV-guided fluid approach to standard fluid management in patients undergoing supratentorial mass excision. Methods: A randomized, controlled study was conducted in Cairo University hospitals ,sixty-one patients scheduled for supratentorial mass excision were randomized into two groups: Control group (Fluid management done through standard fluid management ).Study group (Fluid management done through GDT using PPV). BRS, fluids infused, urine output, hemodynamics, post operative data and post operative hospital stay were compared. Results: A statistically significant difference was found as follow: GDFT group guided by PPV received more number of fluid boluses (p <0.001) and higher total fluids (P=0.002) compared to the control group. Higher urine output (p<0.001 ) and lower postoperative serum lactate (p=0.03) were reported in the GDFT group. BRS together with intraoperative hemodynamic data, Postoperative laboratory investigations and postoperative hospital stay were comparable between both groups

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