Ghandour (2021) Bilateral quadratus lumborum block versus epidural morphine in aortobifemoral bypass graft surgery under general anaesthesia: A prospective randomized controlled study,

Background: The aim of the present study was for comparison of stroke volume versus stroke volume variations as guidance for fluid management under guide directions of electrical cardiometry, during major abdominal surgeries. The primary outcome was to compare between two fluid infusion protocols, regarding the haemodynamic changes, whereas secondary outcomes were to evaluate the impact of each protocol on extravascular lung water and oxygenation changes in the post-operative periods, study the effect of each of the adopted method on postoperative complications, incidence of acute kidney injury and intensive care unit staying duration. Settings and Design: This study was a prospective randomized controlled clinical trial. Methods: The study was carried out on 60 patients scheduled for major abdominal surgery. 30 patients, whose intraoperative fluid administration was managed by stroke volume optimization, were compared with 30 patients who received intraoperative fluid therapy guided by stroke volume variation optimization. Results: There was no difference regarding haemodynamic changes in terms of mean heart rate, mean blood pressure, stroke volume, stroke volume variation, and cardiac index. The first group showed a significant incidence of postoperative pulmonary edema which affected oxygentation process till 24 hours postoperatively.