A Study on the Use of Irrigation Fluids in Neurosurgery

Abstract

Safety and practical use of the irrigation fluids used for neurosurgical patients in 8 hospitals were investigated by a questionary study. For the patients who underwent neuroendoscopic surgery (neuroendoscopic surgery group), an artificial cerebrospinal fluid or lactated Ringer's solution was used, and for the patients receiving cisternal irrigation therapy (cisternal irrigation group), an artificial cerebrospinal fluid was used. For the remaining neurosurgical patients (rinse group) who were not included either in the above two groups, an ordinary saline solution, lactated Ringer's solution, or artificial cerebrospinal fluid was used. In the rinse group, no adverse reactions (AR) were observed. In the neuroendoscopic surgery group, ARs (ex : fever, nausea, vomiting) were observed 6 times in total in the 3 patients administered lactated Ringer's solution; however, no ARs were found in the patients administered the artificial cerebrospinal fluid. In the cisternal irrigation group, ARs (ex : elevated AST, nausea, vomiting) were observed 15 times in total in 7 patients. In this group, the possibility of the relations between the ARs and the artificial cerebrospinal fluid was not excluded; however, the underlying diseases or the cisternal irrigation therapy might be the causes of ARs. In conclusion, the artificial cerebrospinal fluid, which is most similar to the cerebrospinal fluid regarding electrolyte concentrations, pH, and osmotic pressure, was thought to be the most physiological and safe irrigation fluid without bad effects on the patients.