Pin On Pathomporn, Kacha Srisuluk, Saringkarinkul Ananchanok, Thanakititham Nakan
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
PLoS One. 2025 Jun 2;20(6):e0324590. doi: 10.1371/journal.pone.0324590. eCollection 2025.
Suboccipital craniotomy in the park bench position is linked to considerable physiological alterations. Effective fluid management in this context is a challenge to anesthesiologists. No published data exist on pulse pressure variation and central venous pressure guidance in patients undergoing tumor resection in the park bench posture. We undertake a study to evaluate the concept that two approaches of goal-directed fluid treatment enhance optimal fluid management and improve hemodynamic stability. We established the fluid management protocol for this process.
This is a prospective randomized double-blinded study of adult patients undergoing suboccipital craniotomy to remove tumors in the park bench position. The comparison of pulse pressure variation and central venous pressure for fluid management regarding mean intraoperative fluid administration as the primary outcome. A sample size of 54 will yield over 80% power to identify a mean fluid difference of at least 500 ml between two specified methods. The secondary outcomes are data pertinent to fluid administered during and after surgery, including the lowest systolic blood pressure, serum lactate levels, vasopressor utilization, and duration of ICU stay. The statistical analysis will be validated based on the data distribution and types of data. This is the first study to examine two goal-directed fluid therapies, pulse pressure variation and central venous pressure, in patients with posterior fossa tumors and undergoing surgery in the park bench position. Researchers want to contribute novel information to the domain of fluid optimization in neurosurgery.
ClinicalTrials.gov NCT06595667.
在公园长椅体位下行枕下开颅手术会导致相当大的生理改变。在这种情况下，有效的液体管理对麻醉医生来说是一项挑战。目前尚无关于在公园长椅体位下行肿瘤切除术患者的脉压变异和中心静脉压指导方面的已发表数据。我们开展一项研究以评估两种目标导向性液体治疗方法可增强最佳液体管理并改善血流动力学稳定性的概念。我们为此过程制定了液体管理方案。
这是一项针对在公园长椅体位下行枕下开颅肿瘤切除术的成年患者的前瞻性随机双盲研究。以术中平均液体输注量作为主要结局，比较脉压变异和中心静脉压在液体管理中的应用。样本量为54将产生超过80%的把握度，以识别两种特定方法之间至少500毫升的平均液体差异。次要结局是与手术期间及术后输注的液体相关的数据，包括最低收缩压、血清乳酸水平、血管升压药的使用以及重症监护病房停留时间。统计分析将根据数据分布和数据类型进行验证。这是第一项研究在枕下肿瘤患者且在公园长椅体位下行手术中检验两种目标导向性液体疗法，即脉压变异和中心静脉压。研究人员希望为神经外科液体优化领域贡献新的信息。
ClinicalTrials.gov NCT06595667
