Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position
Background and objectives: The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by th...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-09-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001415000950 |
| _version_ | 1811236013854425088 |
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| author | Mehmet Ilke Buget Ata Can Atalar Ipek Saadet Edipoglu Zerrin Sungur Nukhet Sivrikoz Meltem Karadeniz Esra Saka Suleyman Kucukay Mert N. Senturk |
| author_facet | Mehmet Ilke Buget Ata Can Atalar Ipek Saadet Edipoglu Zerrin Sungur Nukhet Sivrikoz Meltem Karadeniz Esra Saka Suleyman Kucukay Mert N. Senturk |
| author_sort | Mehmet Ilke Buget |
| collection | DOAJ |
| description | Background and objectives: The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. Methods: 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients’ internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5 min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4) min. Results: There was a significant decrease between T0 and T1 in heart rate (80.5 ± 11.6 vs. 75.9 ± 14.4 beats/min), MAP (105.8 ± 21.9 vs. 78.9 ± 18.4 mmHg) and PSI (88.5 ± 8.3 vs. 30.3 ± 9.7) (all p < 0.05). Mean arterial pressure decreased significantly after position change, and remained decreased, compared to T1. The overall analysis of patient state index values (T1–T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Conclusion: Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20 min. Resumo: Justificativa e objetivos: O objetivo do estudo foi demonstrar as possíveis alterações hemodinâmicas e do fluxo sanguíneo cerebral (FSC) em pacientes que foram posicionados de supinação para cadeira de praia (CP) e detectar se a mudança de posição causa alguma alteração na atividade cortical como mensurado pelo monitor de EEG com 4 canais. Métodos: No total, 35 pacientes foram incluídos. Antes da indução, os valores da PAM e do IEP foram registrados (T0). Após a intubação, ultrassonografias com Doppler da carótida interna e artérias vertebrais dos pacientes foram avaliadas para adquirir os valores do FSC a partir da fórmula. Em supinação, os valores da PAM, IEP e FSC foram registrados (T1) e o paciente foi posicionado em CP. Após 5 minutos, todas as mensurações foram repetidas (T2). As mensurações do IEP e PAM foram repetidas após 20 (T3) e 40 minutos (T4). Resultados: Houve uma diminuição significativa entre T0 e T1 na FC (80,5 ± 11,6 vs. 75,9 ± 14,4 bpm), PAM (105,8 ± 21,9 vs. 78,9 ± 18,4 mmHg) e IEP (88,5 ± 8,3 vs. 30,3 ± 9,7) (p < 0,05 para todos). A PAM diminuiu significativamente após a mudança de posição e permaneceu diminuída em relação a T1. A análise global dos valores do IEP (T1-T4) não mostrou nenhuma mudança significativa, mas a comparação de apenas T1 e T2 resultou em redução estatisticamente significativa do IEP. Houve redução significativa do FSC após o posicionado em CP. Conclusão: O posicionado em CP foi associado à diminuição do FSC e dos valores do IEP. O IEP foi afetado pela mudança gravitacional do FSC; no entanto, ambos os fatores não estavam diretamente correlacionados entre si. Além disso, a diminuição do valor do IEP foi transitória e voltou aos valores normais dentro de 20 minutos. Keywords: Patient state index, Cerebral, Cerebral blood flow, Beach chair position, Palavras-chave: Patient State Index, Cerebral, Fluxo sanguíneo cerebral, Posição de cadeira de praia |
| first_indexed | 2024-04-12T12:02:11Z |
| format | Article |
| id | doaj.art-1b69aef08ee14f54b4b89b0a3e8f7bb5 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T12:02:11Z |
| publishDate | 2016-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-1b69aef08ee14f54b4b89b0a3e8f7bb52022-12-22T03:33:48ZengElsevierBrazilian Journal of Anesthesiology0104-00142016-09-01665470474Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair positionMehmet Ilke Buget0Ata Can Atalar1Ipek Saadet Edipoglu2Zerrin Sungur3Nukhet Sivrikoz4Meltem Karadeniz5Esra Saka6Suleyman Kucukay7Mert N. Senturk8İstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkey; Corresponding author.İstanbul University, Istanbul Medical Faculty, Department of Orthopedics and Traumatology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, Turkeyİstanbul University, Istanbul Medical Faculty, Department of Anaesthesiology, İstanbul, TurkeyBackground and objectives: The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. Methods: 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0). After the intubation, doppler-ultrasonography of the patients’ internal carotid and vertebral arteries were evaluated to acquire cerebral blood flow values from the formula. In supine position, mean arterial pressure, patient state index and cerebral blood flow values were recorded (T1) and the patient was positioned to beach chair position. After 5 min all measurements were repeated (T2). Measurements of patient state index and mean arterial pressure were repeated after 20 (T3), and 40 (T4) min. Results: There was a significant decrease between T0 and T1 in heart rate (80.5 ± 11.6 vs. 75.9 ± 14.4 beats/min), MAP (105.8 ± 21.9 vs. 78.9 ± 18.4 mmHg) and PSI (88.5 ± 8.3 vs. 30.3 ± 9.7) (all p < 0.05). Mean arterial pressure decreased significantly after position change, and remained decreased, compared to T1. The overall analysis of patient state index values (T1–T4) showed no significant change; however, comparing only T1 and T2 resulted in a statically significant decrease in patient state index. There was a significant decrease in cerebral blood flow after beach chair position. Conclusion: Beach chair position was associated with a decrease in cerebral blood flow and patient state index values. Patient state index was affected by the gravitational change of the cerebral blood flow; however, both factors were not directly correlated to each other. Moreover, the decrease in patient state index value was transient and returned to normal values within 20 min. Resumo: Justificativa e objetivos: O objetivo do estudo foi demonstrar as possíveis alterações hemodinâmicas e do fluxo sanguíneo cerebral (FSC) em pacientes que foram posicionados de supinação para cadeira de praia (CP) e detectar se a mudança de posição causa alguma alteração na atividade cortical como mensurado pelo monitor de EEG com 4 canais. Métodos: No total, 35 pacientes foram incluídos. Antes da indução, os valores da PAM e do IEP foram registrados (T0). Após a intubação, ultrassonografias com Doppler da carótida interna e artérias vertebrais dos pacientes foram avaliadas para adquirir os valores do FSC a partir da fórmula. Em supinação, os valores da PAM, IEP e FSC foram registrados (T1) e o paciente foi posicionado em CP. Após 5 minutos, todas as mensurações foram repetidas (T2). As mensurações do IEP e PAM foram repetidas após 20 (T3) e 40 minutos (T4). Resultados: Houve uma diminuição significativa entre T0 e T1 na FC (80,5 ± 11,6 vs. 75,9 ± 14,4 bpm), PAM (105,8 ± 21,9 vs. 78,9 ± 18,4 mmHg) e IEP (88,5 ± 8,3 vs. 30,3 ± 9,7) (p < 0,05 para todos). A PAM diminuiu significativamente após a mudança de posição e permaneceu diminuída em relação a T1. A análise global dos valores do IEP (T1-T4) não mostrou nenhuma mudança significativa, mas a comparação de apenas T1 e T2 resultou em redução estatisticamente significativa do IEP. Houve redução significativa do FSC após o posicionado em CP. Conclusão: O posicionado em CP foi associado à diminuição do FSC e dos valores do IEP. O IEP foi afetado pela mudança gravitacional do FSC; no entanto, ambos os fatores não estavam diretamente correlacionados entre si. Além disso, a diminuição do valor do IEP foi transitória e voltou aos valores normais dentro de 20 minutos. Keywords: Patient state index, Cerebral, Cerebral blood flow, Beach chair position, Palavras-chave: Patient State Index, Cerebral, Fluxo sanguíneo cerebral, Posição de cadeira de praiahttp://www.sciencedirect.com/science/article/pii/S0104001415000950 |
| spellingShingle | Mehmet Ilke Buget Ata Can Atalar Ipek Saadet Edipoglu Zerrin Sungur Nukhet Sivrikoz Meltem Karadeniz Esra Saka Suleyman Kucukay Mert N. Senturk Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position Brazilian Journal of Anesthesiology |
| title | Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| title_full | Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| title_fullStr | Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| title_full_unstemmed | Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| title_short | Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| title_sort | patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position |
| url | http://www.sciencedirect.com/science/article/pii/S0104001415000950 |
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