Effects of hyperventilation on cerebral oxygen saturation estimated using near-infrared spectroscopy: A randomised comparison between propofol and sevoflurane anaesthesia
Autor: | Noriyuki Shintani, Toru Matsuoka, Masakazu Kotoda, Nobumasa Asano, Takashi Matsukawa, Tadahiko Ishiyama, Kodai Ikemoto |
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Rok vydání: | 2016 |
Předmět: |
Male
Methyl Ethers Cerebral oxygen saturation Sevoflurane 03 medical and health sciences 0302 clinical medicine Oxygen Consumption 030202 anesthesiology Hyperventilation Medicine Tissue oxygen Humans Tissue Distribution Propofol Aged Spectroscopy Near-Infrared business.industry Middle Aged Oxygen Anesthesiology and Pain Medicine Cerebral blood flow Anesthesia Anesthetics Inhalation Female medicine.symptom business Saturation (chemistry) 030217 neurology & neurosurgery Anesthetics Intravenous medicine.drug |
Zdroj: | European journal of anaesthesiology. 33(12) |
ISSN: | 1365-2346 |
Popis: | Near-infrared spectroscopy estimates cerebral regional tissue oxygen saturation (rSO2), which may decrease under hyperventilation. Propofol and sevoflurane act differently on cerebral blood vessels. Consequently, cerebral blood flow during hyperventilation with propofol and sevoflurane anaesthesia may differ.The first aim of this study was to compare the changes in rSO2 between propofol and sevoflurane anaesthesia during hyperventilation. The second aim was to assess changes in rSO2 with ventilation changes.A randomised, open-label study.University of Yamanashi Hospital, Yamanashi, Japan from January 2014 to September 2014.Fifty American Society of Anesthesiologists physical status 1 or 2 adult patients who were scheduled for elective abdominal surgery were assigned randomly to receive either propofol or sevoflurane anaesthesia. Exclusion criterion was a known history of cerebral disease such as cerebral infarction, cerebral haemorrhage, transient ischaemic attack and subarachnoid haemorrhage.After induction of anaesthesia but before the start of surgery, rSO2, arterial carbon dioxide partial pressure (PaCO2) and arterial oxygen saturation were measured. Measurements were repeated at 5-min intervals during 15 min of hyperventilation with a PaCO2 around 30 mmHg (4 kPa), and again after ventilation was normalised.The primary outcome was the difference of changes in rSO2 between propofol anaesthesia and sevoflurane anaesthesia during and after hyperventilation. The second outcome was change in rSO2 after the initiation of hyperventilation and after the normalisation of ventilation.Changes of rSO2 during hyperventilation were -10 ± 7% (left) and -11 ± 8% (right) in the propofol group, and -10 ± 8% (left) and -9 ± 7% (right) in the sevoflurane group. After normalisation of PaCO2, rSO2 returned to baseline values. Arterial oxygen saturation remained stable throughout the measurement period. The rSO2 values were similar in the propofol and the sevoflurane groups at each time point.The effects of hyperventilation on estimated rSO2 were similar with propofol and sevoflurane anaesthesia. Changes in rSO2 correlated well with ventilation changes.Japan Primary Registries Network (JPRN); UMIN-CTR ID; UMIN000010640. |
Databáze: | OpenAIRE |
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