İntrakraniyal Cerrahide 3 Saati Geçen Vakalarda Kan Laktat Seviyelerinin Postoperatif Morbidite ve Mortalite Üzerine Etkileri

Objective: The primary objective of this prospective study was to evaluate the association between intraoperative blood lactate levels, anesthesia duration, and surgical duration and the development of early postoperative morbidity in patients undergoing intracranial surgery lasting more than three hours.Early postoperative mortality was investigated as a prespecified exploratory (descriptive) secondary outcome.Method: This study was planned as a single-center, prospective observational cohort study.After obtaining ethical committee approval, the study was conducted between 1 November 2022 and 1 April 2023.Data from 50 adult patients aged 18-75 years from ASA I-II-III groups who were scheduled for elective craniotomy surgery exceeding 3 hours were collected and analyzed.Results: A total of 50 patients were included in our study, with an average age of 43.06 ± 15.8 and 58% (n=29) being women.The total morbidity rate was 66% (n=33) and the mortality rate was 4% (n=2).No significant relationship was shown between surgical duration and lactate levels.Lactate measurements showed a high correlation between consecutive time points but were not associated with morbidity.Anesthesia duration was 349.09 ± 73.80 minutes in the morbidity group (n=33) and 307.06 ± 69.98 minutes in the non-morbidity group (n=17) (p=0.046).Similarly, surgical durations were 320 ± 72.59 minutes in the morbidity group and 277.06 ± 69.98 minutes in the non-morbidity group (p=0.041).When the relationship between anesthesia duration and morbidity was examined with ROC analysis, sensitivity was found to be 49% and specificity 83% when the cut-off value was 330.At this cut-off value, AUC (area under the curve) was found to be 67%.Conclusion: Intraoperative blood lactate levels were not significantly associated with early postoperative morbidity.However, an anesthesia duration threshold of 330 minutes emerged as a significant predictor of early postoperative morbidity in patients undergoing prolonged intracranial surgery.