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This randomised, double-blinded, single-centre study prospectively investigated the impact of goal directed therapy and fluid optimization with crystalloids or colloids on perioperative complications in patients undergoing brain tumour surgery. Main aim of the study was to investigate the impact of fluid type on postoperative complications. 80 patients were allocated into two equal groups to be optimised with either crystalloids (n = 40) or colloids (n = 40). Invasive hemodynamic monitoring was used to adjust and maintain mean arterial pressure and cerebral oxygenation within the baseline values (± 20%) and stroke volume variation (SVV) ≤ 10%. Postoperative complications from different organ systems were monitored during the first 15 days after surgery. Hospital stay was also recorded. Crystalloid group received significantly more fluids (p = 0.003) and phenylephrine (p = 0.02) compared to colloid group. This did not have any significant impact on perioperative complications and hospital stay, since no differences between groups were observed. Either crystalloids or colloids could be used for fluid optimization in brain tumour surgery. If protocolised perioperative haemodynamic management is used, the type of fluid does not have significant impact on the outcome. [ABSTRACT FROM AUTHOR]

Background: The purpose of this randomised, single-centre study was to prospectively investigate the impact of anaesthetic techniques for craniotomy on the release of cytokines IL-6, IL-8, IL-10, and to determine whether intravenous anaesthesia compared to inhalational anaesthesia attenuates the inflammatory response. Methods: The study enroled 40 patients undergoing craniotomy, allocated into two equal groups to receive either sevoflurane (n = 20) or propofol (n = 20) in conjunction with remifentanil and rocuronium. The lungs were ventilated mechanically to maintain normocapnia. Remifentanil infusion was adjusted according to the degree of surgical manipulation and increased when mean arterial pressure and the heart rate increased by more than 30 % from baseline. The depth of anaesthesia was adjusted to maintain a bispectral index (BIS) of 40-60. Invasive haemodynamic monitoring was used. Serum levels of IL-6, IL-8 and IL-10 were measured before surgery and anaesthesia, during tumour removal, at the end of surgery, and at 24 and 48 h after surgery. Postoperative complications (pain, vomiting, changes in blood pressure, infection and pulmonary, cardiovascular and neurological events) were monitored during the first 15 days after surgery. Results: Compared with patients anaesthetised with sevoflurane, patients who received propofol had higher levels of IL-10 (p = 0.0001) and lower IL-6/IL-10 concentration ratio during and at the end of surgery (p = 0.0001). Both groups showed only a minor response of IL- 8 during and at the end of the surgery (p = 0.57). Conclusions: Patients who received propofol had higher levels of IL-10 during surgery. Neither sevoflurane nor propofol had any significant impact on the occurrence of postoperative complications. Our findings should incite future studies to prove a potential medically important anti-inflammatory role of propofol in neuroanaesthesia. Clinical trial registration: Identified as NCT02229201 at www.clinicaltrials.gov [ABSTRACT FROM AUTHOR]