Limitations in utilization of sodium fluorescein as a contrast agent during brain surgery

Although today’s neurosurgery worldwide accepts the use of sodium fluorescein as a useful intraoperative contrast agent, there are several limitations and disadvantages of its utilization. Human medicine requires continuous research and development. Thus we made a clinical study that will provide useful information about some specific details about the use of sodium fluorescein intraoperative for brain tumors. In advance, we are looking forward in improving the fluorescent surgery and overcoming these disadvantages. Sodium fluorescein has a great potential as an intraoperative contrast agent and overcoming these limitations will lead to a more successful outcome. Material and methods: Specific information about sodium fluorescein’s characteristics was gained from 39 patients operated with its utilization during surgery of brain tumors. All of these patients were injected intravenously sodium fluorescein at a dose of 5mg/kg prior to skin incision. During surgery, operative microscope Zeiss Kinevo 900 with “white” (daylight) and “yellow” (with 560nm filter) was used. The data was collected during a period of 3 years from year 2022 to 2025. Details were discussed during surgery and notes were taken weather tumor margins are clear or blur. Patients’ neurological status was assessed after surgery. Imagine methods such as MRI and CT scans pre and post operatively were compared in order to assess the extent of tumor resection. Days of hospital stay were used as an indirect indicator of postoperative complications. All this data was helpful in estimating surgical success using sodium fluorescein intraoperative. However, the goal of this study is to emphasise the problems and disadvantages that we encountered utilizing sodium fluorescein. Thus, the analytical part is of greater value, than the numerical. Conclusion: Sodium fluorescein is useful adjunct for brain tumor surgery. However, in some specific cases and situations it can guide the neurosurgeon in wrong direction and cause unwanted damage. Therefore, every neurosurgeon who utilizes sodium fluorescein for tumor resection need to receive thorough education for its characteristics first. In the hands of skilled and experienced neurosurgeon these limitations can be overwhelmed and sodium fluorescein guided surgery can contribute to greater overall surgical success.