Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial
Purpose Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. W...
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| Veröffentlicht in: | Journal of anesthesia 2017-12, Vol.31 (6), p.829-836 |
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| creator | Mukaihara, Keika Hasegawa-Moriyama, Maiko Kanmura, Yuichi |
| description | Purpose
Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB.
Methods
Thirty-four patients undergoing elective thoracotomy were enrolled. Patients were randomly assigned to a group receiving only GA, or GA combined with PVB (GA + PVB). Changes in cerebral oxygenated hemoglobin (ΔO
2
Hb), deoxygenated-Hb (ΔHHb), and total-Hb (ΔtotalHb) were evaluated by NIRS as surgery began.
Results
In the GA group, ΔO
2
Hb was significantly higher in the hemisphere contralateral to the side of surgery when the incision was made and 2 min after incision compared with the ipsilateral side (start of surgery,
P
|
| doi_str_mv | 10.1007/s00540-017-2402-7 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1932168787</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A514101130</galeid><sourcerecordid>A514101130</sourcerecordid><originalsourceid>FETCH-LOGICAL-c473t-878d80d19558f8530305f1e37324cef88863b6d27e6fd28761f89cb0e05b2c3f3</originalsourceid><addsrcrecordid>eNp9kt2K1TAQx4so7nH1AbyRgDfedJ00_Ui9Ww5-wYI3eh3SdNpmTZNjkq4e38y3M90eBeEggSTM_GYyM_ln2XMKVxSgeR0AqhJyoE1elFDkzYNsR0vGc86q9mG2g5aynNc1v8iehHALADWl7HF2UXDOaoB2l_3aOxu9NDJi2olCj916mXB2o3GdtsT9OI5oSZBx8TJqZ4mapB0xkOQ8JAvaGMhie_Sj03YkcXJeKhfdfCTfdZxICr_PLi2GOGHQcrM7f3-6JaY8Xt6hj9vrnXHq6xsiiZe2d7P-iT1Ra6HOmHSNXkvzNHs0SBPw2em8zL68e_t5_yG_-fT-4_76Jldlw2LOG95z6GlbVXzgFQMG1UCRNawoFQ6c85p1dV80WA99wZuaDrxVHSBUXaHYwC6zV1veg3ffltSAmHVQaEzqxi1B0JYVtE7PNAl9uaGjNCi0HVwarVpxcV3RkkKaPiQqP0OdZuQsDjqZ_-GvzvBp9ThrdTaAbgHKuxA8DuLg9Sz9UVAQq3DEJhyRhCNW4Yi19BenLpduxv5vxB-lJKDYgJBc6fe9uHWLt2ny_8n6G1eu0V0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1932168787</pqid></control><display><type>article</type><title>Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Mukaihara, Keika ; Hasegawa-Moriyama, Maiko ; Kanmura, Yuichi</creator><creatorcontrib>Mukaihara, Keika ; Hasegawa-Moriyama, Maiko ; Kanmura, Yuichi</creatorcontrib><description>Purpose
Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB.
Methods
Thirty-four patients undergoing elective thoracotomy were enrolled. Patients were randomly assigned to a group receiving only GA, or GA combined with PVB (GA + PVB). Changes in cerebral oxygenated hemoglobin (ΔO
2
Hb), deoxygenated-Hb (ΔHHb), and total-Hb (ΔtotalHb) were evaluated by NIRS as surgery began.
Results
In the GA group, ΔO
2
Hb was significantly higher in the hemisphere contralateral to the side of surgery when the incision was made and 2 min after incision compared with the ipsilateral side (start of surgery,
P
< 0.01; 2 min,
P
< 0.05). In contrast, there were no significant changes in the ΔO
2
Hb at any of the time points in the GA + PVB group. Comparable with ΔO
2
Hb, the concentration of ΔtotalHb was significantly higher in the contralateral hemisphere in the GA group at the start of surgery (
P
< 0.05).
Conclusions
Changes in the cerebral O
2
Hb concentration were detected by NIRS immediately after surgical incision under GA, but not in the presence of a PNB. NIRS could be used to monitor surgical pain. PVB inhibited changes in oxygenation induced by incision-provoked pain.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-017-2402-7</identifier><identifier>PMID: 28836009</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Anesthesia ; Anesthesia, General - methods ; Anesthesiology ; Critical Care Medicine ; Dosage and administration ; Emergency Medicine ; Female ; Health aspects ; Hemoglobins ; Hemoglobins - metabolism ; Humans ; Infrared spectroscopy ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nerve Block - methods ; Original Article ; Oxygen - metabolism ; Pain Medicine ; Pain, Postoperative - epidemiology ; Spectroscopy, Near-Infrared ; Thoracotomy ; Thoracotomy - methods</subject><ispartof>Journal of anesthesia, 2017-12, Vol.31 (6), p.829-836</ispartof><rights>Japanese Society of Anesthesiologists 2017</rights><rights>COPYRIGHT 2017 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-878d80d19558f8530305f1e37324cef88863b6d27e6fd28761f89cb0e05b2c3f3</citedby><cites>FETCH-LOGICAL-c473t-878d80d19558f8530305f1e37324cef88863b6d27e6fd28761f89cb0e05b2c3f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-017-2402-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-017-2402-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28836009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukaihara, Keika</creatorcontrib><creatorcontrib>Hasegawa-Moriyama, Maiko</creatorcontrib><creatorcontrib>Kanmura, Yuichi</creatorcontrib><title>Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Purpose
Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB.
Methods
Thirty-four patients undergoing elective thoracotomy were enrolled. Patients were randomly assigned to a group receiving only GA, or GA combined with PVB (GA + PVB). Changes in cerebral oxygenated hemoglobin (ΔO
2
Hb), deoxygenated-Hb (ΔHHb), and total-Hb (ΔtotalHb) were evaluated by NIRS as surgery began.
Results
In the GA group, ΔO
2
Hb was significantly higher in the hemisphere contralateral to the side of surgery when the incision was made and 2 min after incision compared with the ipsilateral side (start of surgery,
P
< 0.01; 2 min,
P
< 0.05). In contrast, there were no significant changes in the ΔO
2
Hb at any of the time points in the GA + PVB group. Comparable with ΔO
2
Hb, the concentration of ΔtotalHb was significantly higher in the contralateral hemisphere in the GA group at the start of surgery (
P
< 0.05).
Conclusions
Changes in the cerebral O
2
Hb concentration were detected by NIRS immediately after surgical incision under GA, but not in the presence of a PNB. NIRS could be used to monitor surgical pain. PVB inhibited changes in oxygenation induced by incision-provoked pain.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia, General - methods</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Dosage and administration</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hemoglobins</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Infrared spectroscopy</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nerve Block - methods</subject><subject>Original Article</subject><subject>Oxygen - metabolism</subject><subject>Pain Medicine</subject><subject>Pain, Postoperative - epidemiology</subject><subject>Spectroscopy, Near-Infrared</subject><subject>Thoracotomy</subject><subject>Thoracotomy - methods</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt2K1TAQx4so7nH1AbyRgDfedJ00_Ui9Ww5-wYI3eh3SdNpmTZNjkq4e38y3M90eBeEggSTM_GYyM_ln2XMKVxSgeR0AqhJyoE1elFDkzYNsR0vGc86q9mG2g5aynNc1v8iehHALADWl7HF2UXDOaoB2l_3aOxu9NDJi2olCj916mXB2o3GdtsT9OI5oSZBx8TJqZ4mapB0xkOQ8JAvaGMhie_Sj03YkcXJeKhfdfCTfdZxICr_PLi2GOGHQcrM7f3-6JaY8Xt6hj9vrnXHq6xsiiZe2d7P-iT1Ra6HOmHSNXkvzNHs0SBPw2em8zL68e_t5_yG_-fT-4_76Jldlw2LOG95z6GlbVXzgFQMG1UCRNawoFQ6c85p1dV80WA99wZuaDrxVHSBUXaHYwC6zV1veg3ffltSAmHVQaEzqxi1B0JYVtE7PNAl9uaGjNCi0HVwarVpxcV3RkkKaPiQqP0OdZuQsDjqZ_-GvzvBp9ThrdTaAbgHKuxA8DuLg9Sz9UVAQq3DEJhyRhCNW4Yi19BenLpduxv5vxB-lJKDYgJBc6fe9uHWLt2ny_8n6G1eu0V0</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Mukaihara, Keika</creator><creator>Hasegawa-Moriyama, Maiko</creator><creator>Kanmura, Yuichi</creator><general>Springer Japan</general><general>Springer</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>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial</title><author>Mukaihara, Keika ; Hasegawa-Moriyama, Maiko ; Kanmura, Yuichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-878d80d19558f8530305f1e37324cef88863b6d27e6fd28761f89cb0e05b2c3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia, General - methods</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Dosage and administration</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hemoglobins</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Infrared spectroscopy</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nerve Block - methods</topic><topic>Original Article</topic><topic>Oxygen - metabolism</topic><topic>Pain Medicine</topic><topic>Pain, Postoperative - epidemiology</topic><topic>Spectroscopy, Near-Infrared</topic><topic>Thoracotomy</topic><topic>Thoracotomy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukaihara, Keika</creatorcontrib><creatorcontrib>Hasegawa-Moriyama, Maiko</creatorcontrib><creatorcontrib>Kanmura, Yuichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukaihara, Keika</au><au>Hasegawa-Moriyama, Maiko</au><au>Kanmura, Yuichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>31</volume><issue>6</issue><spage>829</spage><epage>836</epage><pages>829-836</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Purpose
Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB.
Methods
Thirty-four patients undergoing elective thoracotomy were enrolled. Patients were randomly assigned to a group receiving only GA, or GA combined with PVB (GA + PVB). Changes in cerebral oxygenated hemoglobin (ΔO
2
Hb), deoxygenated-Hb (ΔHHb), and total-Hb (ΔtotalHb) were evaluated by NIRS as surgery began.
Results
In the GA group, ΔO
2
Hb was significantly higher in the hemisphere contralateral to the side of surgery when the incision was made and 2 min after incision compared with the ipsilateral side (start of surgery,
P
< 0.01; 2 min,
P
< 0.05). In contrast, there were no significant changes in the ΔO
2
Hb at any of the time points in the GA + PVB group. Comparable with ΔO
2
Hb, the concentration of ΔtotalHb was significantly higher in the contralateral hemisphere in the GA group at the start of surgery (
P
< 0.05).
Conclusions
Changes in the cerebral O
2
Hb concentration were detected by NIRS immediately after surgical incision under GA, but not in the presence of a PNB. NIRS could be used to monitor surgical pain. PVB inhibited changes in oxygenation induced by incision-provoked pain.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>28836009</pmid><doi>10.1007/s00540-017-2402-7</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of anesthesia, 2017-12, Vol.31 (6), p.829-836 |
| issn | 0913-8668 1438-8359 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Anesthesia Anesthesia, General - methods Anesthesiology Critical Care Medicine Dosage and administration Emergency Medicine Female Health aspects Hemoglobins Hemoglobins - metabolism Humans Infrared spectroscopy Intensive Male Medicine Medicine & Public Health Middle Aged Nerve Block - methods Original Article Oxygen - metabolism Pain Medicine Pain, Postoperative - epidemiology Spectroscopy, Near-Infrared Thoracotomy Thoracotomy - methods |
| title | Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial |
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