Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial

Abstract Study objective To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcS o2 ) during laparoscopic cholecystectomy. Design Randomized, prospective and single-blinded study. Setting Academic hospital. Patients ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014. Measurements Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TC o2 ), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtC o2 ), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia. Main results Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcS o2 values. Statistically higher rSc o2 values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TC o2 , TrtC o2 , Tpost, Trec30 and Trec60 and incidence of critical rcS o2 decreases was statistically lower in VIMA group ( P < .05). There were no serious perioperative complications. Conclusions VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.