Lactate levels during anesthesia in patients undergoing craniopharyngioma surgery.

Purpose: To assess the incidence of hyperlactatemia and lactic acidosis in patients undergoing craniopharyngioma surgery and to investigate their association with surgical outcomes. Method: We analyzed clinical data from all patients who underwent craniopharyngioma surgery between 2019 and 2023 at a tertiary care center. Arterial blood gas analyses were performed prior to anesthesia and at one-hour intervals during surgery. Patients were classified into three groups: the Lactic Acidosis group (LA), Hyperlactatemia group (HL), and Normal Control group (NC). The primary outcome was the occurrence of postoperative severe hypernatremia (serum sodium levels exceeding 155 mmol/L). Results: We enrolled 261 patients with a mean age of 41.7 years. During anesthesia, mean lactate levels increased from 1.4 [1.0-1.9] mmol/L at initiation to 4.6 [1.8-7.0] mmol/L after 8 h. Among the cohort, 44 patients (16.9%) were classified in the HL group and 31 patients (11.9%) in the LA group. Anesthesia duration was the sole factor significantly associated with increased lactate levels in both univariate and multivariable analyses (OR 1.50 [95% CI: 1.31-1.80], Conclusion: Lactate levels increased during anesthesia in patients undergoing craniopharyngioma surgery and were associated with postoperative hypernatremia. However, with appropriate management, lactic acidosis was not significantly linked to adverse postoperative outcomes.