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The effects of sevoflurane and propofol anesthesia on cerebral oxygenation in gynecological laparoscopic surgery.

Kim SJ, Kwon JY, Cho AR, Kim HK, Kim TK - Korean J Anesthesiol (2011)

Bottom Line: Also anesthetic agents have variable effects on cerebral hemodynamics and ICP.Between sevoflurane and propofol groups, the change in rSO(2) was significantly different even after ANCOVA. rSO(2) at Tpt (76.3 ± 5.9% in sevoflurane vs 69.4 ± 5.8% in propofol) and Tpost (69.5 ± 7.1% in sevoflurane vs 63.8 ± 6.6% in propofol) were significantly higher in the sevoflurane group compared with the propofol group.In the propofol group, rSO(2) at Tpost was significantly lower than at Tpre (71.1 ± 4.8%) and cerebral oxygen desaturation occurred in two patients (14.3%).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Pain Medicine, Pusan National University Hospital, Busan, Korea.

ABSTRACT

Background: Both the Trendelenburg position and pneumoperitoneum with carbon dioxide have been reported to increase intracranial pressure (ICP) and to alter cerebral blood flow or cerebral blood volume. Also anesthetic agents have variable effects on cerebral hemodynamics and ICP. The present study was conducted to determine whether regional cerebral oxygen saturation (rSO(2)) values differ between propofol and sevoflurane anesthesia during laparoscopic surgery in the Trendelenburg position.

Methods: Thirty-two adult women undergoing gynecological laparoscopic surgery were divided into sevoflurane and propofol groups. rSO(2) values were recorded at 10 min after induction in the neutral position (Tpre), 10 min after the pneumoperitoneum in the Trendelenburg position (Tpt) and 10 min after desufflation in the neutral position (Tpost). For analysis of rSO(2), we did ANOVA and univariate two-way ANCOVA with covariates being mean arterial pressure and end tidal carbon dioxide tension.

Results: Between sevoflurane and propofol groups, the change in rSO(2) was significantly different even after ANCOVA. rSO(2) at Tpt (76.3 ± 5.9% in sevoflurane vs 69.4 ± 5.8% in propofol) and Tpost (69.5 ± 7.1% in sevoflurane vs 63.8 ± 6.6% in propofol) were significantly higher in the sevoflurane group compared with the propofol group. In the propofol group, rSO(2) at Tpost was significantly lower than at Tpre (71.1 ± 4.8%) and cerebral oxygen desaturation occurred in two patients (14.3%).

Conclusions: Significantly lower rSO(2) values were observed in the propofol group during gynecological laparoscopic surgery. The possibility of cerebral oxygen desaturation should not be overlooked during propofol anesthesia even after desufflation of the abdomen in the neutral position.

No MeSH data available.


Related in: MedlinePlus

Changes in regional cerebral oxygen saturation. Values are mean ± SD, Tpre: baseline, 10 min after induction of general anesthesia in the neutral position, Tpt: 10 min after insufflation of the abdomen with CO2 in the Trendelenburg position, Tpost: 10 min after desufflation of the abdomen in the neutral position, rSO2: regional cerebral oxygen saturation. *P < 0.05 vs propofol group, †P < 0.05 vs Tpre with ANOVA.
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Figure 1: Changes in regional cerebral oxygen saturation. Values are mean ± SD, Tpre: baseline, 10 min after induction of general anesthesia in the neutral position, Tpt: 10 min after insufflation of the abdomen with CO2 in the Trendelenburg position, Tpost: 10 min after desufflation of the abdomen in the neutral position, rSO2: regional cerebral oxygen saturation. *P < 0.05 vs propofol group, †P < 0.05 vs Tpre with ANOVA.

Mentions: Demographic variables are shown in Table 1. There was no significant difference in demographic variables between the two groups. The change in rSO2 is shown in Fig. 1. There was a significant difference between the two groups in rSO2 (P = 0.027 with ANOVA, P = 0.021 with ANCOVA). At Tpt, the rSO2 value was 76.3 ± 5.9% for the sevoflurane group and 69.4 ± 5.8% for the propofol group. At Tpost, the rSO2 value was 69.5 ± 7.1% in the sevoflurane group and 63.8 ± 6.6% in the propofol group. The rSO2 values at Tpt and Tpost were significantly higher in the sevoflurane group compared with the propofol group (P = 0.015 at Tpt, P = 0.048 at Tpost). In the sevoflurane group, the change in rSO2 was statistically significant by ANOVA (P = 0.028) but was not significant with ANCOVA (P = 0.957). Similarly, in the propofol group, the change in rSO2 was statistically significant with ANOVA (P = 0.020) but was not significant with ANCOVA (P = 0.350). In the sevoflurane group, rSO2 at Tpt was higher than at Tpre but the difference was not significant (P = 0.028, Bonferroni/Dunn correction). In the propofol group, rSO2 at Tpost was significantly lower than at Tpre (P = 0.013).


The effects of sevoflurane and propofol anesthesia on cerebral oxygenation in gynecological laparoscopic surgery.

Kim SJ, Kwon JY, Cho AR, Kim HK, Kim TK - Korean J Anesthesiol (2011)

Changes in regional cerebral oxygen saturation. Values are mean ± SD, Tpre: baseline, 10 min after induction of general anesthesia in the neutral position, Tpt: 10 min after insufflation of the abdomen with CO2 in the Trendelenburg position, Tpost: 10 min after desufflation of the abdomen in the neutral position, rSO2: regional cerebral oxygen saturation. *P < 0.05 vs propofol group, †P < 0.05 vs Tpre with ANOVA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198184&req=5

Figure 1: Changes in regional cerebral oxygen saturation. Values are mean ± SD, Tpre: baseline, 10 min after induction of general anesthesia in the neutral position, Tpt: 10 min after insufflation of the abdomen with CO2 in the Trendelenburg position, Tpost: 10 min after desufflation of the abdomen in the neutral position, rSO2: regional cerebral oxygen saturation. *P < 0.05 vs propofol group, †P < 0.05 vs Tpre with ANOVA.
Mentions: Demographic variables are shown in Table 1. There was no significant difference in demographic variables between the two groups. The change in rSO2 is shown in Fig. 1. There was a significant difference between the two groups in rSO2 (P = 0.027 with ANOVA, P = 0.021 with ANCOVA). At Tpt, the rSO2 value was 76.3 ± 5.9% for the sevoflurane group and 69.4 ± 5.8% for the propofol group. At Tpost, the rSO2 value was 69.5 ± 7.1% in the sevoflurane group and 63.8 ± 6.6% in the propofol group. The rSO2 values at Tpt and Tpost were significantly higher in the sevoflurane group compared with the propofol group (P = 0.015 at Tpt, P = 0.048 at Tpost). In the sevoflurane group, the change in rSO2 was statistically significant by ANOVA (P = 0.028) but was not significant with ANCOVA (P = 0.957). Similarly, in the propofol group, the change in rSO2 was statistically significant with ANOVA (P = 0.020) but was not significant with ANCOVA (P = 0.350). In the sevoflurane group, rSO2 at Tpt was higher than at Tpre but the difference was not significant (P = 0.028, Bonferroni/Dunn correction). In the propofol group, rSO2 at Tpost was significantly lower than at Tpre (P = 0.013).

Bottom Line: Also anesthetic agents have variable effects on cerebral hemodynamics and ICP.Between sevoflurane and propofol groups, the change in rSO(2) was significantly different even after ANCOVA. rSO(2) at Tpt (76.3 ± 5.9% in sevoflurane vs 69.4 ± 5.8% in propofol) and Tpost (69.5 ± 7.1% in sevoflurane vs 63.8 ± 6.6% in propofol) were significantly higher in the sevoflurane group compared with the propofol group.In the propofol group, rSO(2) at Tpost was significantly lower than at Tpre (71.1 ± 4.8%) and cerebral oxygen desaturation occurred in two patients (14.3%).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia and Pain Medicine, Pusan National University Hospital, Busan, Korea.

ABSTRACT

Background: Both the Trendelenburg position and pneumoperitoneum with carbon dioxide have been reported to increase intracranial pressure (ICP) and to alter cerebral blood flow or cerebral blood volume. Also anesthetic agents have variable effects on cerebral hemodynamics and ICP. The present study was conducted to determine whether regional cerebral oxygen saturation (rSO(2)) values differ between propofol and sevoflurane anesthesia during laparoscopic surgery in the Trendelenburg position.

Methods: Thirty-two adult women undergoing gynecological laparoscopic surgery were divided into sevoflurane and propofol groups. rSO(2) values were recorded at 10 min after induction in the neutral position (Tpre), 10 min after the pneumoperitoneum in the Trendelenburg position (Tpt) and 10 min after desufflation in the neutral position (Tpost). For analysis of rSO(2), we did ANOVA and univariate two-way ANCOVA with covariates being mean arterial pressure and end tidal carbon dioxide tension.

Results: Between sevoflurane and propofol groups, the change in rSO(2) was significantly different even after ANCOVA. rSO(2) at Tpt (76.3 ± 5.9% in sevoflurane vs 69.4 ± 5.8% in propofol) and Tpost (69.5 ± 7.1% in sevoflurane vs 63.8 ± 6.6% in propofol) were significantly higher in the sevoflurane group compared with the propofol group. In the propofol group, rSO(2) at Tpost was significantly lower than at Tpre (71.1 ± 4.8%) and cerebral oxygen desaturation occurred in two patients (14.3%).

Conclusions: Significantly lower rSO(2) values were observed in the propofol group during gynecological laparoscopic surgery. The possibility of cerebral oxygen desaturation should not be overlooked during propofol anesthesia even after desufflation of the abdomen in the neutral position.

No MeSH data available.


Related in: MedlinePlus