Effects of Sodium Bicarbonate Ringer's Solution versus Lactate Ringer's Solution on Emergence Time in Patients Undergoing Supratentorial Tumor Resection: A Randomized Controlled Trial.
Jie Wang, Yechun Wang, Dutian Wang et al.
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In 30 seconds
This randomized controlled trial compared intraoperative sodium bicarbonate Ringer’s solution (BRS) with lactated Ringer’s solution (LRS) in patients undergoing elective supratentorial tumor resection. In the intention-to-treat analysis of 100 patients, median emergence time was shorter with BRS than LRS (13min vs 16min; median difference, 3; 95% CI, 1 to 4; P =0.003). Extubation was also faster with BRS. Early post-extubation SOMCT scores, postoperative complications and hospital stay were comparable between groups.
Key findings
- Median emergence time was 13min with BRS versus 16min with LRS (median difference, 3; 95% CI, 1 to 4; P =0.003).
- Extubation time was 15min with BRS versus 18min with LRS (median difference, 2; 95% CI, 1 to 4; P =0.01).
- BRS was associated with lower lactate at the end of surgery and 0.5 hour after extubation (P < 0.05).
- SOMCT scores at 15 min after extubation, postoperative complications and total hospitalization days were comparable (P > 0.05).
Why it matters
Prompt emergence can facilitate postoperative neurological assessment after supratentorial tumor surgery. In this trial, BRS was associated with faster emergence and extubation than LRS, while measured early cognitive scores and clinical outcomes were similar. The findings help characterize recovery profiles with these intraoperative fluids, but do not establish that the timing differences improve neurological assessment or patient outcomes.
What to keep in mind
The trial was limited to elective supratentorial tumor resection; the abstract does not report longer-term neurological outcomes.