Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study
Abstract Background The monitoring of regional cerebral oxygen saturation (SrO2) using near-infrared spectroscopy is useful method to detect cerebral ischemia during. Sevoflurane and propofol decrease cerebral metabolic rate (CMRO2) in a similar manner, but the effects on the cerebral blood flow (CB...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0820-9 |
| _version_ | 1818244202886070272 |
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| author | Sanghee Park Keunbae Yook Kyung Yeon Yoo Jeong Il Choi Hong-Beom Bae Youngwook You Baoyuan Jin Seongtae Jeong |
| author_facet | Sanghee Park Keunbae Yook Kyung Yeon Yoo Jeong Il Choi Hong-Beom Bae Youngwook You Baoyuan Jin Seongtae Jeong |
| author_sort | Sanghee Park |
| collection | DOAJ |
| description | Abstract Background The monitoring of regional cerebral oxygen saturation (SrO2) using near-infrared spectroscopy is useful method to detect cerebral ischemia during. Sevoflurane and propofol decrease cerebral metabolic rate (CMRO2) in a similar manner, but the effects on the cerebral blood flow (CBF) are different. We hypothesized that the effects of sevoflurane and propofol on SrO2 were different in patients with deficits of CBF. This study compared the effect of sevoflurane and propofol on SrO2 of patients undergoing cerebral endarterectomy (CEA). Method Patients undergoing CEA were randomly assigned to the sevoflurane or propofol group (n = 74). The experiment was preceded in 2 stages based on carotid artery clamping. The first stage was from induction of anaesthesia to immediately before clamping of the carotid artery, and the second stage was until the end of the operation after clamping of the carotid artery. Oxygen saturation (SrO2, SpO2), haemodynamic variables (blood pressure, heart rate), respiratory parameters (end-tidal carbon dioxide tension, inspired oxygen tension), concentration of anesthetics, and anesthesia depth (bispectral index score) were recorded. Results During stage 1 period (before carotid artery clamping), the mean value of the relative changes in SrO2 was higher (P = 0.033) and the maximal decrease in SrO2 was lower in the sevoflurane group compared with the propofol group (P = 0.019) in the contralateral (normal) site. However, there is no difference in ipsilateral site (affected site). SrO2 decreased after carotid artery clamping and increased after declamping, but the difference was not significant between two groups. Changes in mean arterial blood pressure was lower in sevoflurane group than propofol group after the carotid artery declamping (P = 0.048). Conclusion Propofol-remifentanil anesthesia was comparable with sevoflurane-remifentanil anesthesia in an aspect of preserving the SrO2 in patients undergoing carotid endarterectomy. Trial registration Clinical Trials.gov identifier: NCT02609087, retrospectively registered on November 18, 2015. |
| first_indexed | 2024-12-12T14:13:17Z |
| format | Article |
| id | doaj.art-8624f1897c084b22827fe353eae161c2 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-12T14:13:17Z |
| publishDate | 2019-08-01 |
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| series | BMC Anesthesiology |
| spelling | doaj.art-8624f1897c084b22827fe353eae161c22022-12-22T00:21:59ZengBMCBMC Anesthesiology1471-22532019-08-0119111010.1186/s12871-019-0820-9Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled studySanghee Park0Keunbae Yook1Kyung Yeon Yoo2Jeong Il Choi3Hong-Beom Bae4Youngwook You5Baoyuan Jin6Seongtae Jeong7Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalDepartment of Anesthesiology and Pain Medicine, Chonnam National University Medical School and HospitalAbstract Background The monitoring of regional cerebral oxygen saturation (SrO2) using near-infrared spectroscopy is useful method to detect cerebral ischemia during. Sevoflurane and propofol decrease cerebral metabolic rate (CMRO2) in a similar manner, but the effects on the cerebral blood flow (CBF) are different. We hypothesized that the effects of sevoflurane and propofol on SrO2 were different in patients with deficits of CBF. This study compared the effect of sevoflurane and propofol on SrO2 of patients undergoing cerebral endarterectomy (CEA). Method Patients undergoing CEA were randomly assigned to the sevoflurane or propofol group (n = 74). The experiment was preceded in 2 stages based on carotid artery clamping. The first stage was from induction of anaesthesia to immediately before clamping of the carotid artery, and the second stage was until the end of the operation after clamping of the carotid artery. Oxygen saturation (SrO2, SpO2), haemodynamic variables (blood pressure, heart rate), respiratory parameters (end-tidal carbon dioxide tension, inspired oxygen tension), concentration of anesthetics, and anesthesia depth (bispectral index score) were recorded. Results During stage 1 period (before carotid artery clamping), the mean value of the relative changes in SrO2 was higher (P = 0.033) and the maximal decrease in SrO2 was lower in the sevoflurane group compared with the propofol group (P = 0.019) in the contralateral (normal) site. However, there is no difference in ipsilateral site (affected site). SrO2 decreased after carotid artery clamping and increased after declamping, but the difference was not significant between two groups. Changes in mean arterial blood pressure was lower in sevoflurane group than propofol group after the carotid artery declamping (P = 0.048). Conclusion Propofol-remifentanil anesthesia was comparable with sevoflurane-remifentanil anesthesia in an aspect of preserving the SrO2 in patients undergoing carotid endarterectomy. Trial registration Clinical Trials.gov identifier: NCT02609087, retrospectively registered on November 18, 2015.http://link.springer.com/article/10.1186/s12871-019-0820-9Carotid endarterectomyRegional cerebral oxygen saturationNear-infrared spectroscopyPropofolSevoflurane |
| spellingShingle | Sanghee Park Keunbae Yook Kyung Yeon Yoo Jeong Il Choi Hong-Beom Bae Youngwook You Baoyuan Jin Seongtae Jeong Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study BMC Anesthesiology Carotid endarterectomy Regional cerebral oxygen saturation Near-infrared spectroscopy Propofol Sevoflurane |
| title | Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study |
| title_full | Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study |
| title_fullStr | Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study |
| title_full_unstemmed | Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study |
| title_short | Comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy: a prospective, randomized controlled study |
| title_sort | comparison of the effect of sevoflurane or propofol anesthesia on the regional cerebral oxygen saturation in patients undergoing carotid endarterectomy a prospective randomized controlled study |
| topic | Carotid endarterectomy Regional cerebral oxygen saturation Near-infrared spectroscopy Propofol Sevoflurane |
| url | http://link.springer.com/article/10.1186/s12871-019-0820-9 |
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