Investigation of the post-operative recovery period of patients with laparoscopic sleeve gastrectomy managed with goal-directed fluid therapy

Obesity causes early death because of additional diseases accompanied. Success of goal directed fluid therapy protocols is wellkown on patient prognosis. Effects of Pleth Variability Index (PVI), Systolic Pressure Exchange (SPV) and Pulse Pressure Exchange (PPV) techniques were evaluated in this study; which are used for measurement of tissue perfusion and maintaining kidney function After obtaining the approval of the ethics committee, a total of 210 patients between 01/02/2019 and 01/08/2019 were included in the prospective, randomized controlled clinical study. Demographic data, hemodynamic parameters, amount of colloid and crystalloid fluids and goal directed fluid therapy management technique were recorded. Patients were randomized divided into three groups as PVI (n = 70), PPV (n = 70) and SPV (n = 70) according to the goal directed fluid therapy management technique applied. Routine preoperative anesthetic, general anesthesia application and recovery protocols were applied to the patients. The amount of colloid in the SPV group was significantly lower than PVI group and no significant difference was found in the other binary group comparisons. There was no significant difference between the groups in terms of crystalloid amounts, lactate, urea and creatinine values. Goal directed fluid therapy managements performed in laparoscopic sleeve gastrectomy surgery with PVI, SPV and PPV measurement techniques; the three groups were not superior to each other in the postoperative recovery period by investigating tissue perfusion, kidney function, return time of bowel movements and length of hospital stay. As a result, goal directed fluid therapy protocols in bariatric surgeries prevent intraoperative fluid overload and further research is needed to optimize the techniques. Key Words: PVI, SPV, PPV, Bariatric Surgery, Lactate