Blood Biochemistry Following Endoscopic Third Ventriculostomy

Abstract

Background: Endoscopic third ventriculostomy (ETV) is now an accepted treatment for obstructive hydrocephalus. Anandh et al. have reported postoperative hyperkalemia following ETV. However, due to small sample size (20 patients), the authors could not confirm their hypothesis (8). Therefore, we have conducted the present study in order to investigate postoperative blood chemistry following ETV.

Patients and Methods: The computerized database and the medical records of 50 patients who underwent ETV under general anesthesia were studied. Blood chemistry for all patients was done preoperatively as well as for three consecutive days postoperatively. Preoperative and peak postoperative serum blood chemistry variables were compared by using Student's t-test for paired samples. A p value of < 0.05 was considered significant.

Results: Preoperative serum K⁺ concentration mean value was 4.8 ± 0.7 mmol/l. In the consecutive two postoperative days serum K⁺ levels mean values were 4.4 ± 0.8 and 4.3 ± 0.8 mmol/l with significantly lower levels compared to preoperative values (p < 0.05).

Conclusions: Although significantly lower K⁺ values have occurred in our series postoperatively, they were of no clinical significance. Moreover, our results were in contrast to Anandh et al. who used lactated Ringer's (LR) as irrigation fluid which led to postoperative hyperkalemia. We recommend the use of normal saline as irrigation fluid instead of LR.

Endoscopic third ventriculostomy - general anesthesia - complications

References

• 1 Jones R, Stening W, Brydon M. Endoscopic third ventriculostomy.  Neurosurgery. 1990;  26 86-92
• 2 Sainte-Rose C, Chumas P. Endoscopic third ventriculostomy.  Techniques in Neurosurgery. 1996;  1 176-184
• 3 Cohen A, Shucart W A. Ventriculoscopic management of colloid cysts of the third ventricle. In: Manwaring KH, Crone K (eds.). Neuroendoscopy. New York: Mary Ann Libert 1992 1: 109-117
• 4 McLaughlin M R, Wahlig J B, Kaufmann A M, Leland A lbright. Traumatic basilar aneurysm after endoscopic third ventriculostomy: Case report.  Neurosurgery. 1997;  41 1400-1404
• 5 EI-Dawlatly A A, Murshid W, EI-Khwsky F. Endoscopic third ventriculostomy: A study of intracranial pressure vs. haemodynamic changes.  Minim Invas Neurosurg. 1999;  42 198-200
• 6 EI-Dawlatly A A, Murshid W R, Elshimy A. The incidence of bradycardia during endoscopic third ventriculostomy.  Anesth Analg. 2000;  91 1142-1144
• 7 Ambesh S P, Kumar R. Neuroendoscopic procedures: Anesthetic considerations for growing trend - A review.  J Neurosurg Anesthesiol. 2000;  12 262-270
• 8 Anandh B, Madhusudan Reddy K R, Mohanty A. Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy.  Minim Invas Neurosurg. 2002;  45 154-157