Fengzhi Liu1,2, Jing Lv3, Weixia Zhang4, Zhongkai Liu2, Ling Dong1, Yuelan Wang1. 1. Department of Anesthesiology and Perioperative Medicine, Qianfoshan Hospital Affiliated to Shandong University Jinan 250014, Shandong, China. 2. Department of Anesthesiology, Linyi People's Hospital Linyi 276003, Shandong, China. 3. Department of Anesthesiology, Zibo Central Hospital Zibo 255000, Shandong, China. 4. Department of Critical Care, Linyi People's Hospital Linyi 276003, Shandong, China.
Abstract
BACKGROUND: A randomized, double-blinded controlled trial was performed to evaluate how perioperative goal-directed fluid therapy (GDFT) influences tissue oxygenation in laparoscopic colorectal surgery. METHODS: A total of 74 patients undergoing elective laparoscopic colorectal surgery were treated with GDFT (G group) guided by stroke volume variation or conventional fluid therapy (C group). Forearm, crural, and cerebral tissue oxygen saturation (rSO2) were simultaneously measured by near-infrared spectroscopy. Parameters of hemodynamics and rSO2 were obtained at seven time points including before induction of anesthesia (T1), 5 min after trachea cannula (T2), 5, 60, and 120 min after pneumoperitoneum in the Trendeleburg position (T3, T4 and T5, respectively), after desufflation in the Trendeleburg position (T6), and at the end of the operation in a supine position (T7). The postoperative outcomes were recorded. RESULTS: Compared to C group, intraoperatively, patients in the G group received more colloid (P<0.05). The stroke volume variation in G group at T5, T6 and T7 was significantly lower than that in C group (P<0.05). The cardiac index, forearm and crural rSO2 in G group at T4, T5, T6 and T7 were significantly higher than those in C group (P<0.05). No significant differences were observed for the cerebral rSO2 between the two groups (P > 0.05). The postoperative hospital stay and complications also showed no differences between these two groups. CONCLUSIONS: Although the implementation of GDFT cannot increase cerebral rSO2, the forearm and crural rSO2 are improved during the laparoscopic colorectal surgery, which is helpful to reduce the risk of regional tissue hypoxia. IJCEP
RCT Entities:
BACKGROUND: A randomized, double-blinded controlled trial was performed to evaluate how perioperative goal-directed fluid therapy (GDFT) influences tissue oxygenation in laparoscopic colorectal surgery. METHODS: A total of 74 patients undergoing elective laparoscopic colorectal surgery were treated with GDFT (G group) guided by stroke volume variation or conventional fluid therapy (C group). Forearm, crural, and cerebral tissue oxygen saturation (rSO2) were simultaneously measured by near-infrared spectroscopy. Parameters of hemodynamics and rSO2 were obtained at seven time points including before induction of anesthesia (T1), 5 min after trachea cannula (T2), 5, 60, and 120 min after pneumoperitoneum in the Trendeleburg position (T3, T4 and T5, respectively), after desufflation in the Trendeleburg position (T6), and at the end of the operation in a supine position (T7). The postoperative outcomes were recorded. RESULTS: Compared to C group, intraoperatively, patients in the G group received more colloid (P<0.05). The stroke volume variation in G group at T5, T6 and T7 was significantly lower than that in C group (P<0.05). The cardiac index, forearm and crural rSO2 in G group at T4, T5, T6 and T7 were significantly higher than those in C group (P<0.05). No significant differences were observed for the cerebral rSO2 between the two groups (P > 0.05). The postoperative hospital stay and complications also showed no differences between these two groups. CONCLUSIONS: Although the implementation of GDFT cannot increase cerebral rSO2, the forearm and crural rSO2 are improved during the laparoscopic colorectal surgery, which is helpful to reduce the risk of regional tissue hypoxia. IJCEP
Authors: Marie K Jessen; Mikael F Vallentin; Mathias J Holmberg; Maria Bolther; Frederik B Hansen; Johanne M Holst; Andreas Magnussen; Niklas S Hansen; Cecilie M Johannsen; Johannes Enevoldsen; Thomas H Jensen; Lara L Roessler; Peter C Lind; Maibritt P Klitholm; Mark A Eggertsen; Philip Caap; Caroline Boye; Karol M Dabrowski; Lasse Vormfenne; Maria Høybye; Jeppe Henriksen; Carl M Karlsson; Ida R Balleby; Marie S Rasmussen; Kim Pælestik; Asger Granfeldt; Lars W Andersen Journal: Br J Anaesth Date: 2021-12-13 Impact factor: 11.719
Authors: Johanne M Holst; Maibritt P Klitholm; Jeppe Henriksen; Mikael F Vallentin; Marie K Jessen; Maria Bolther; Mathias J Holmberg; Maria Høybye; Peter Carøe Lind; Asger Granfeldt; Lars W Andersen Journal: Acta Anaesthesiol Scand Date: 2022-08-22 Impact factor: 2.274