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...
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| Veröffentlicht in: | Journal of clinical anesthesia 2017-02, Vol.36, p.110-117 |
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| creator | Ružman, Tomislav, MD Šimurina, Tatjana, MD, PhD Gulam, Danijela, MD, PhD Ružman, Nataša, MD, PhD Miškulin, Maja, MD, PhD |
| description | 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. |
| doi_str_mv | 10.1016/j.jclinane.2016.10.010 |
| format | Article |
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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.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2016.10.010</identifier><identifier>PMID: 28183546</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdominal surgery ; Adult ; Aged ; Anesthesia ; Anesthesia & Perioperative Care ; Anesthesia, General - adverse effects ; Anesthesia, General - methods ; Anesthetics, Inhalation - pharmacology ; Anesthetics, Intravenous - pharmacology ; Blood Pressure - drug effects ; Brain hypoxia ; Cholecystectomy ; Cholecystectomy, Laparoscopic - adverse effects ; Cholecystectomy, Laparoscopic - methods ; Female ; Heart rate ; Heart Rate - drug effects ; Humans ; Hypoxia ; Hypoxia, Brain - etiology ; Hypoxia, Brain - prevention & control ; Laparoscopic ; Laparoscopy ; Male ; Metabolism ; Methyl Ethers - pharmacology ; Middle Aged ; Near infrared ; Oxygen - blood ; Oxygen Consumption - drug effects ; Pain Medicine ; Patients ; Propofol ; Propofol - pharmacology ; Prospective Studies ; Sensors ; Sevoflurane ; Single-Blind Method ; Spectroscopy ; Spectroscopy, Near-Infrared ; Spectrum analysis ; Young Adult</subject><ispartof>Journal of clinical anesthesia, 2017-02, Vol.36, p.110-117</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-2548372d7860c2c58831fbd0d16be3139d59d51a986023b238aa1dd9cd0e784e3</citedby><cites>FETCH-LOGICAL-c484t-2548372d7860c2c58831fbd0d16be3139d59d51a986023b238aa1dd9cd0e784e3</cites><orcidid>0000-0001-7330-3019</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2024086827?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28183546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ružman, Tomislav, MD</creatorcontrib><creatorcontrib>Šimurina, Tatjana, MD, PhD</creatorcontrib><creatorcontrib>Gulam, Danijela, MD, PhD</creatorcontrib><creatorcontrib>Ružman, Nataša, MD, PhD</creatorcontrib><creatorcontrib>Miškulin, Maja, MD, PhD</creatorcontrib><title>Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>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.</description><subject>Abdominal surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia & Perioperative Care</subject><subject>Anesthesia, General - adverse effects</subject><subject>Anesthesia, General - methods</subject><subject>Anesthetics, Inhalation - pharmacology</subject><subject>Anesthetics, Intravenous - pharmacology</subject><subject>Blood Pressure - drug effects</subject><subject>Brain hypoxia</subject><subject>Cholecystectomy</subject><subject>Cholecystectomy, Laparoscopic - adverse effects</subject><subject>Cholecystectomy, Laparoscopic - methods</subject><subject>Female</subject><subject>Heart rate</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Hypoxia, Brain - etiology</subject><subject>Hypoxia, Brain - prevention & control</subject><subject>Laparoscopic</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Metabolism</subject><subject>Methyl Ethers - pharmacology</subject><subject>Middle Aged</subject><subject>Near infrared</subject><subject>Oxygen - blood</subject><subject>Oxygen Consumption - drug effects</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Propofol</subject><subject>Propofol - pharmacology</subject><subject>Prospective Studies</subject><subject>Sensors</subject><subject>Sevoflurane</subject><subject>Single-Blind Method</subject><subject>Spectroscopy</subject><subject>Spectroscopy, Near-Infrared</subject><subject>Spectrum analysis</subject><subject>Young Adult</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk1v1DAQhi0EotvCX6giceGSxV9JHA4IVFFAqoRE4Ww59qR4640X21mx_Hom2raHXkCy_DHzzNiedwg5Z3TNKGvfbNYbG_xkJlhzPKNxTRl9QlZMdaKWDe-fkhXtG14rpugJOc15QylFB3tOTjgaRSPbFbm9hn0cw5wwU7VLkCHtIVcJbnycTKgsJBgSbuLvww1MVTYF2YLOaoBSIFXlp5kwMu7iGMPb6puZXNz6P-AqG6eSYgi4Lcmb8II8G03I8PJuPSM_Lj9-v_hcX3399OXiw1VtpZKl5o1UouOuUy213DZKCTYOjjrWDiCY6F2Dg5ke_VwMXChjmHO9dRQ6JUGckdfHvPiqXzPkorc-WwgB_xjnrLFEHG8QUvwH2naN5EL2iL56hG7inLBGWXPKJVWt4h1S7ZGyKeacYNS75LcmHTSjelFOb_S9cnpRbrGjchh4fpd-HrbgHsLupULg_REALN3eQ9LZepgsOJ_AFu2i__cd7x6lWChvTbiFA-SH_zCduab6eumfpX1YK2iPk_gL3q_CrQ</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Ružman, Tomislav, MD</creator><creator>Šimurina, Tatjana, MD, PhD</creator><creator>Gulam, Danijela, MD, PhD</creator><creator>Ružman, Nataša, MD, PhD</creator><creator>Miškulin, Maja, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0001-7330-3019</orcidid></search><sort><creationdate>20170201</creationdate><title>Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial</title><author>Ružman, Tomislav, MD ; Šimurina, Tatjana, MD, PhD ; Gulam, Danijela, MD, PhD ; Ružman, Nataša, MD, PhD ; Miškulin, Maja, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-2548372d7860c2c58831fbd0d16be3139d59d51a986023b238aa1dd9cd0e784e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia & Perioperative Care</topic><topic>Anesthesia, General - adverse effects</topic><topic>Anesthesia, General - methods</topic><topic>Anesthetics, Inhalation - pharmacology</topic><topic>Anesthetics, Intravenous - pharmacology</topic><topic>Blood Pressure - drug effects</topic><topic>Brain hypoxia</topic><topic>Cholecystectomy</topic><topic>Cholecystectomy, Laparoscopic - adverse effects</topic><topic>Cholecystectomy, Laparoscopic - methods</topic><topic>Female</topic><topic>Heart rate</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Hypoxia, Brain - etiology</topic><topic>Hypoxia, Brain - prevention & control</topic><topic>Laparoscopic</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Metabolism</topic><topic>Methyl Ethers - pharmacology</topic><topic>Middle Aged</topic><topic>Near infrared</topic><topic>Oxygen - blood</topic><topic>Oxygen Consumption - drug effects</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Propofol</topic><topic>Propofol - pharmacology</topic><topic>Prospective Studies</topic><topic>Sensors</topic><topic>Sevoflurane</topic><topic>Single-Blind Method</topic><topic>Spectroscopy</topic><topic>Spectroscopy, Near-Infrared</topic><topic>Spectrum analysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ružman, Tomislav, MD</creatorcontrib><creatorcontrib>Šimurina, Tatjana, MD, PhD</creatorcontrib><creatorcontrib>Gulam, Danijela, MD, PhD</creatorcontrib><creatorcontrib>Ružman, Nataša, MD, PhD</creatorcontrib><creatorcontrib>Miškulin, Maja, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ružman, Tomislav, MD</au><au>Šimurina, Tatjana, MD, PhD</au><au>Gulam, Danijela, MD, PhD</au><au>Ružman, Nataša, MD, PhD</au><au>Miškulin, Maja, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>36</volume><spage>110</spage><epage>117</epage><pages>110-117</pages><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28183546</pmid><doi>10.1016/j.jclinane.2016.10.010</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7330-3019</orcidid></addata></record> |
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| subjects | Abdominal surgery Adult Aged Anesthesia Anesthesia & Perioperative Care Anesthesia, General - adverse effects Anesthesia, General - methods Anesthetics, Inhalation - pharmacology Anesthetics, Intravenous - pharmacology Blood Pressure - drug effects Brain hypoxia Cholecystectomy Cholecystectomy, Laparoscopic - adverse effects Cholecystectomy, Laparoscopic - methods Female Heart rate Heart Rate - drug effects Humans Hypoxia Hypoxia, Brain - etiology Hypoxia, Brain - prevention & control Laparoscopic Laparoscopy Male Metabolism Methyl Ethers - pharmacology Middle Aged Near infrared Oxygen - blood Oxygen Consumption - drug effects Pain Medicine Patients Propofol Propofol - pharmacology Prospective Studies Sensors Sevoflurane Single-Blind Method Spectroscopy Spectroscopy, Near-Infrared Spectrum analysis Young Adult |
| title | Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial |
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