Effect of goal-directed fluid therapy versus standard fluid therapy on cuff leak gradient in patients with complex spine surgery in prone position

Objective To compare the effects of goal-directed fluid therapy (GFT) versus standard fluid therapy (SFT) on cuff leak gradient (CLG), postoperative sore throat and hoarseness in patients with complex spine surgery in prone position.

Methods A total of 90 patients with complex spinal surgery in prone position were randomly divided into GFT group and SFT group, with 45 cases in each group. Patients in the GFT group received GFT, while the patients in the SFT group received SFT. The dyspnea and the second intubation caused by laryngeal edema or stridor within 48 h after operation were recorded; the patients' sore throat and hoarseness within 24 hours after operation were evaluated; the patients' hospitalization time and stay time in ICU were recorded.

Results The stay time in ICU in the GFT group was significantly shorter than that in the SFT group (P < 0.05). The cuff leak value before extubation (CLV_BE) in the GFT group was significantly higher than that in the SFT group, while the CLG was significantly lower than that in the SFT group (P < 0.05). The score of sore throat, score of hoarseness and the number of cases with hoarseness in the GFT group were significantly lower than those in the SFT group (P < 0.05). The number of cases with sore throat in the GFT group were lower than those in the SFT group, but the difference was not statistically significant (P=0.054).

Conclusion Compared with SFT, GFT can significantly reduce the risk of postoperative laryngealedema, reduce the incidence rates of postoperative sore throat and hoarseness, and shorten the ICU stay in patients with complex spine surgery in prone position.