Effect of Two-Stage Goal-Directed Crystalloid versus Colloid Fluid Therapy on Postoperative Quality of Recovery in Patients Undergoing Laparoscopic Hepatectomy: A Randomized Controlled Trial.

OBJECTIVE

This study aimed to investigate the impact of two-stage goal-directed crystalloid versus colloid fluid therapy on postoperative quality of recovery in patients undergoing laparoscopic hepatectomy.

PATIENTS AND

METHODS

A total of 116 patients scheduled for elective laparoscopic hepatectomy were randomly assigned to two groups: the goal-directed fluid therapy (GDFT) crystalloid group and the GDFT colloid group. Both groups were monitored for stroke volume variation (SVV) using the FloTrac/Vigileo system, and GDFT was guided based on SVV values. Primary outcome was the 24 h postoperative Quality of Recovery-15 (QoR-15) score. Secondary outcome included the estimated blood loss, lactate levels, total fluid infusion volume, hemodynamic status, postoperative nausea and vomiting (PONV) scores, pain scores, postoperative liver and kidney function, and the incidence of postoperative complications.

RESULTS

There was no significant difference in the total QoR-15 scores between the two groups at each point in time (P > 0.05). Compared with the crystalloid group, the colloid group had lower PONV scores at 24 and 48 h postoperatively, fewer times of rescue fluid infusion, and a lower total fluid infusion volume (P < 0.05). Multiple linear regression analysis showed that the estimated blood loss (β = -0.268, P = 0.005) and PONV (β = -0.176, P = 0.045) score were associated with postoperative recovery.

CONCLUSION

Two-stage goal-directed crystalloid versus colloid fluid therapy had no significant difference in the postoperative quality of recovery in patients undergoing laparoscopic hepatectomy, which is the primary finding of this study. Nevertheless, our data indicated that colloids may reduce postoperative nausea and vomiting (PONV), though this observation requires confirmation in larger-scale trials.