Tomislav Ružman1, Tatjana Šimurina2, Danijela Gulam3, Nataša Ružman4, Maja Miškulin5. 1. Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Osijek, J. Huttlera 4, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia; Our Lady of Lourdes Hospital Drogheda, Boyle O'Reilly Terrace, Drogheda, Co Louth, Ireland. 2. Department of Anesthesiology and ICU, General Hospital Zadar, Bože Peričića 5, Zadar,Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia; Department of Health Study, University of Zadar, Mihovila Pavlinovića 1, Zadar, Croatia. Electronic address: tatjana.simurina@gmail.com. 3. Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Osijek, J. Huttlera 4, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia. 4. Institute of Public Health for Osijek-Baranya County, Franje Krežme 1, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia. 5. Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia.
Abstract
STUDY OBJECTIVE: To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. DESIGN: Randomized, prospective and single-blinded study. SETTING: Academic hospital. PATIENTS: ASA physical status of I and IIsurgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014. MEASUREMENTS: Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo2), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtCo2), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia. MAIN RESULTS:Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo2 values. Statistically higher rSco2 values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo2, TrtCo2, Tpost, Trec30 and Trec60 and incidence of critical rcSo2 decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications. CONCLUSIONS:VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.
RCT Entities:
STUDY OBJECTIVE: To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. DESIGN: Randomized, prospective and single-blinded study. SETTING: Academic hospital. PATIENTS: ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014. MEASUREMENTS: Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo2), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtCo2), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia. MAIN RESULTS: Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo2 values. Statistically higher rSco2 values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo2, TrtCo2, Tpost, Trec30 and Trec60 and incidence of critical rcSo2 decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications. CONCLUSIONS:VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.