Intraoperative Fluid Management for Major Neurosurgery: Narrative study
Hussein Ali Hussein, Majid Fakhir Alhamaidah, Hussein Alkhfaji, Maytham T. Qasim, Ammar Hoom Al-Nussairi, Hamza Sh. Abd-Alzahra
Abstract
neuroanesthesia and critical care for neurosurgical patients, the anesthesiologist plan should have a judicious regimen of fluid management because it will be obliging in improve the surgical outcomes. When the fluids is replaced by a good regimen, it will help the neurosurgeon to avoid brain edema formation and intravenous congestion whereas enhancing the patient's volume status to maintain both adequate cerebral perfusion and oxygenation. We searched the current available literature and RCTs on MEDLINE, EMBASE and Cochrane Evidence Based Medicine Reviews. Furthermore, citation review and hand search of new journals related to fluid therapy for neuro-surgeries were done. Because of absent any specific evidence which concerning the optimal fluid and regimen of replacement, at least the regimen that are demonstrated to be harmful should be avoided. Thoughtful preoperative appreciatin of the pathophysiology of the individual patient is an effective maner to have a suitable desion in type and amount of fluid. Every thing should be normal, this is the main objective from fluid management during neurosurgery and can be achieved by maintaining the continuity of each of glocuse level, sodium level and intravascular volume within normality.