Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study
Abstract Background We evaluated the change of cerebral regional tissue oxygen saturation (rSO2) along with the pneumoperitoneum and the Trendelenburg position. We also assessed the relationship between the change of rSO2 and the changes of mean arterial blood pressure (MAP), heart rate (HR), arteri...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-05-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0736-4 |
| _version_ | 1818305614219051008 |
|---|---|
| author | Toru Matsuoka Tadahiko Ishiyama Noriyuki Shintani Masakazu Kotoda Kazuha Mitsui Takashi Matsukawa |
| author_facet | Toru Matsuoka Tadahiko Ishiyama Noriyuki Shintani Masakazu Kotoda Kazuha Mitsui Takashi Matsukawa |
| author_sort | Toru Matsuoka |
| collection | DOAJ |
| description | Abstract Background We evaluated the change of cerebral regional tissue oxygen saturation (rSO2) along with the pneumoperitoneum and the Trendelenburg position. We also assessed the relationship between the change of rSO2 and the changes of mean arterial blood pressure (MAP), heart rate (HR), arterial carbon dioxide tension (PaCO2), arterial oxygen tension (PaO2), or arterial oxygen saturation (SaO2). Methods Forty-one adult patients who underwent a robotic assisted endoscopic prostatic surgery under propofol and remifentanil anesthesia were involved in this study. During the surgery, a pneumoperitoneum was established using carbon dioxide. Measurements of rSO2, MAP, HR, PaCO2, PaO2, and SaO2 were performed before the pneumoperitoneum (baseline), every 5 min after the onset of pneumoperitoneum, before the Trendelenburg position. After the onset of the Trendelenburg position, rSO2, MAP, HR were recorded at 5, 10, 20, 30, 45, and 60 min, and PaCO2, PaO2, and SaO2 were measured at 10, 30, and 60 min. Results Before the pneumoperitoneum, left and right rSO2 were 67.9 ± 6.3% and 68.5 ± 7.0%. Ten minutes after the onset of pneumoperitoneum, significant increase in the rSO2 was observed (left: 69.6 ± 5.9%, right: 70.6 ± 7.4%). During the Trendelenburg position, the rSO2 increased initially and peaked at 5 min (left: 72.2 ± 6.5%, right: 73.1 ± 7.6%), then decreased. Multiple regression analysis showed that change of rSO2 correlated with MAP and PaCO2. Conclusions Pneumoperitoneum and the Trendelenburg position in robotic-assisted endoscopic prostatic surgery did not worsen cerebral oxygenation. Arterial blood pressure is the critical factor in cerebral oxygenation. Trial registration Japan Primary Registries Network (JPRN); UMIN-CTR ID; UMIN000026227 (retrospectively registered). |
| first_indexed | 2024-12-13T06:29:23Z |
| format | Article |
| id | doaj.art-554e125027ab4318b6d30a30a8c95651 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-13T06:29:23Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-554e125027ab4318b6d30a30a8c956512022-12-21T23:56:39ZengBMCBMC Anesthesiology1471-22532019-05-011911810.1186/s12871-019-0736-4Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational studyToru Matsuoka0Tadahiko Ishiyama1Noriyuki Shintani2Masakazu Kotoda3Kazuha Mitsui4Takashi Matsukawa5Department of Anesthesiology, Faculty of Medicine, University of YamanashiSurgical Center, University of Yamanashi Hospital, University of YamanashiSurgical Center, University of Yamanashi Hospital, University of YamanashiDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiSurgical Center, University of Yamanashi Hospital, University of YamanashiDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiAbstract Background We evaluated the change of cerebral regional tissue oxygen saturation (rSO2) along with the pneumoperitoneum and the Trendelenburg position. We also assessed the relationship between the change of rSO2 and the changes of mean arterial blood pressure (MAP), heart rate (HR), arterial carbon dioxide tension (PaCO2), arterial oxygen tension (PaO2), or arterial oxygen saturation (SaO2). Methods Forty-one adult patients who underwent a robotic assisted endoscopic prostatic surgery under propofol and remifentanil anesthesia were involved in this study. During the surgery, a pneumoperitoneum was established using carbon dioxide. Measurements of rSO2, MAP, HR, PaCO2, PaO2, and SaO2 were performed before the pneumoperitoneum (baseline), every 5 min after the onset of pneumoperitoneum, before the Trendelenburg position. After the onset of the Trendelenburg position, rSO2, MAP, HR were recorded at 5, 10, 20, 30, 45, and 60 min, and PaCO2, PaO2, and SaO2 were measured at 10, 30, and 60 min. Results Before the pneumoperitoneum, left and right rSO2 were 67.9 ± 6.3% and 68.5 ± 7.0%. Ten minutes after the onset of pneumoperitoneum, significant increase in the rSO2 was observed (left: 69.6 ± 5.9%, right: 70.6 ± 7.4%). During the Trendelenburg position, the rSO2 increased initially and peaked at 5 min (left: 72.2 ± 6.5%, right: 73.1 ± 7.6%), then decreased. Multiple regression analysis showed that change of rSO2 correlated with MAP and PaCO2. Conclusions Pneumoperitoneum and the Trendelenburg position in robotic-assisted endoscopic prostatic surgery did not worsen cerebral oxygenation. Arterial blood pressure is the critical factor in cerebral oxygenation. Trial registration Japan Primary Registries Network (JPRN); UMIN-CTR ID; UMIN000026227 (retrospectively registered).http://link.springer.com/article/10.1186/s12871-019-0736-4Cerebral oxygenationEndoscopic prostatic surgeryPneumoperitoneumTrendelenburg position |
| spellingShingle | Toru Matsuoka Tadahiko Ishiyama Noriyuki Shintani Masakazu Kotoda Kazuha Mitsui Takashi Matsukawa Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study BMC Anesthesiology Cerebral oxygenation Endoscopic prostatic surgery Pneumoperitoneum Trendelenburg position |
| title | Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study |
| title_full | Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study |
| title_fullStr | Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study |
| title_full_unstemmed | Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study |
| title_short | Changes of cerebral regional oxygen saturation during pneumoperitoneum and Trendelenburg position under propofol anesthesia: a prospective observational study |
| title_sort | changes of cerebral regional oxygen saturation during pneumoperitoneum and trendelenburg position under propofol anesthesia a prospective observational study |
| topic | Cerebral oxygenation Endoscopic prostatic surgery Pneumoperitoneum Trendelenburg position |
| url | http://link.springer.com/article/10.1186/s12871-019-0736-4 |
| work_keys_str_mv | AT torumatsuoka changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy AT tadahikoishiyama changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy AT noriyukishintani changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy AT masakazukotoda changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy AT kazuhamitsui changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy AT takashimatsukawa changesofcerebralregionaloxygensaturationduringpneumoperitoneumandtrendelenburgpositionunderpropofolanesthesiaaprospectiveobservationalstudy |