Evaluating the Effect of Adding Furosemide to Hypertonic Saline 5% on the Intracranial Pressure in Candidates of Craniotomy for Resection of Supratentorial Brain Tumors

Abstract

Background: Increasing in intracranial pressure is a life-threatening condition during craniotomy surgery, which increases the incidence of complications and mortality in patients. Therefore, it is necessary to find a way to cure this complication. The purpose of this study was to evaluate the effect of adding furosemide to hypertonic saline 5% on intracranial pressure changes in patients with craniotomy surgery for resection of supratentorial tumors. Methods: This study was performed on 65 candidate for craniotomy surgery (33 patients in the intervention group and 32 in the control group). Patients were randomly divided into two groups; the intervention group received 5 ml/kg saline hypertonic 5% plus 0.05 cc/kg furosemide, and the control group received 5 ml/kg saline hypertonic 5% plus 0.05 cc/kg distilled water. Vital signs and intracranial pressure were recorded in patients. Findings: The relaxation after cranial openings in the intervention group was significantly lower (1.66 versus 2.37) (P = 0.001), and also relaxation before the opening of the dura (1.33 versus 1.81) (P = 0.009). However, there was no difference in the hemodynamic parameters and the length of stay in the hospital (P > 0.050 for all). Conclusion: Adding furosemide to hypertonic saline 5% improves and decreases intracranial pressure in patients with craniotomy surgery for resection of supratentorial tumors.

Keywords

• Hypertonic saline solution
• Furosemide
• Intracranial pressure