Compare the efficacy of hypertonic saline vs mannitol as an anti-edema measure, in cases of head injury

Abstract

Background: To study the efficacy and safety of 3% hypertonic saline and compare with 20% mannitol in the management of moderate to severe head injury. Material and Methods: Group A (patients treated with Mannitol) n=30, Group B (patients treated with 3% hypertonic saline) n=30. Intervention protocol Dose of Mannitol 20% 2ml/Kg infused over 20 minutes 6 or 8 hourly for the group A. Group B infused with 3% 2ml/Kg Hypertonic Saline over 20 minutes. Safety and efficacy compared. Results: There was no significant difference in mortality. The duration of coma hours was also not very different. There was no difference in the neurological outcomes of both groups. No significant untoward complications observed in both the groups which were found to be related to the drug. hypertonic saline (3%) therapy in case of moderate to severe head injury is found to be as safe and as efficacious as mannitol. No significant hypernatremia is seen in 97% of our patients of hypertonic saline (3%) group. Conclusion: In our comparative prospective study, it can be concluded that the efficiency of 20% Mannitol and 3% Hypertonic Saline for the treatment of cerebral edema in patients with moderate to severe head injury is almost equal.