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Abstract

COMPARISON OF THE EFFECTS OF MANNITOL AND HYPERTONIC SALINE 5% ON ELECTROLYTE BALANCES DURING BRAIN TUMOR SURGERY

Nasajian Nozar, Salary Amir, Janatmakan Farahzad, Soltani Farhad, Rajab Zadeh
Hengameh and Javaherforoosh Zadeh Fatemeh*

ABSTRACT

Introduction: This study attempts to compare the effect of mannitol and hypertonic saline 5% on electrolyte balance of patients undergoing brain tumor surgery. Methods: In this study, 34 patients were placed in two groups mannitol 20% and hypertonic saline 5% as a randomized double blind prospective clinical trial. Primary end points included: The amount of electrolytes (sodium, potassium, chloride and bicarbonate) before anesthesia, during induction, 120 minutes after the start of treatment and also at the end of surgery. The secondary end point were amount of bleeding, urinary output, heart rate and systolic and diastolic blood pressure of patients at the start of anesthesia, at 30, 60, 90 and 120 minutes after onset of anesthesia. Results: There was a significant difference between the two groups in amount of sodium and chloride during the surgery (p<0.05). There was no significant difference between groups in concentrations of potassium and bicarbonate (p>0.05). Hemodynamic variables of patients showed that there was a significant difference between groups at 120 minutes (p<0.05). Urine output was higher with mannitol than hypertonic saline in the 90 (p = 0.035) and 120 minutes (p = 0.041) respectively. Also there was no significant difference between the two groups in amount of bleeding at none of the times (p>0.05). Conclusion: It can be concluded hypertonic saline increases the concentration of electrolytes and provides a more appropriate hemodynamic status than the mannitol. Hypertonic saline was associated with less diuretic effect; therefore generally the hypertonic saline can be used as a substitute for mannitol.

Keywords: Mannitol, Hypertonic Saline, Brain Tumor.


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