A COMPARISON OF THREE DIFFERENT DOSES OF MANNITOL ON BRAIN RELAXATION DURING SUPRATENTORIAL BRAIN TUMOUR CRANIOTOMY

BACKGROUND A comparison of three different doses of mannitol on brain relaxation during supratentorial brain tumour craniotomy. Supratentorial tumours produce significant mass effects in the brain and certain types are accompanied by significant peritumoral oedema that leads to increased intracranial pressure. Higher osmotic pressure in the blood vessels after the infusion of mannitol drives water molecules from the brain tissue to blood vessels and results in brain tissue dehydration. The point of my study is to determine a dose that leads to a beneficial effect without triggering negative effects. MATERIALS AND METHODS This is a prospective, randomised single-blinded study conducted in Konaseema Institute of Medical Sciences, Amalapuram, from March 2015 to March 2017. After getting ethical committee approval and informed consent, 48 patients of both sexes (male and female) who underwent elective craniotomy for supratentorial tumour surgeries under general anaesthesia at were taken up for study. 48 patients were divided into three groups as group-A, group-B and group-C with 16 in each group. RESULTS There is significant change in brain relaxation score with increasing dose of mannitol. MAP and pH are significant with increasing dose of mannitol, serum sodium and potassium levels are also significant. Anion gap and urine output also showed significant change. Age, sex and BMI are not statistically significant. CONCLUSION From this study, it is concluded that 1.5 mg/kg of 20% mannitol gives better brain relaxation scores than 0.5 mg/kg of 20% mannitol and 1.0 mg/kg of 20% mannitol.