Anesth Pain Med.  2021 Jul;16(3):215-224. 10.17085/apm.21072.

Fluid management in patients undergoing neurosurgery

  • 1Department of Anesthesiology and Pain Medicine, Daegu Catholic University School of Medicine, Daegu, Korea


Fluid management is an important component of perioperative care for patients undergoing neurosurgery. The primary goal of fluid management in neurosurgery is the maintenance of normovolemia and prevention of serum osmolarity reduction. To maintain normovolemia, it is important to administer fluids in appropriate amounts following appropriate methods, and to prevent a decrease in serum osmolarity, the choice of fluid is essential. There is considerable debate about the choice and optimal amounts of fluids administered in the perioperative period. However, there is little high-quality clinical research on fluid therapy for patients undergoing neurosurgery. This review will discuss the choice and optimal amounts of fluids in neurosurgical patients based on the literature, recent issues, and perioperative fluid management practices.


Albumin; Colloids; Crystalloid solutions; Fluid therapy; Hemodynamics; Neurosurgery


  • Fig. 1. Dynamic parameters derived from the arterial pressure wave. Mechanical ventilation induces periodic changes in the arterial waveform. Various parameters are derived from this periodic change. Pulse pressure (PP) is the difference between the systolic and diastolic pressures. The area under curve of the arterial pressure wave represents the stroke volume (SV). Systolic pressure variation (SPV) is the difference between the maximum and minimal systolic pressures. SPV consists of two components, delta up (Δup) and delta down (Δdown), by reference pressure (Pref). Pref is the systolic pressure measured at the end of expiration or during apnea. PPV: pulse pressure variation, SVV: stroke volume variation.


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