Minimal and normal-flow general anesthesia in patients undergoing surgery in prone position: ımpact on hemodynamics and regional cerebral oxygenation
Acta Cirurgica Brasileira, cilt.38, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 38
- Basım Tarihi: 2023
- Doi Numarası: 10.1590/acb380523
- Dergi Adı: Acta Cirurgica Brasileira
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
- Anahtar Kelimeler: Hemodynamics, Spectroscopy, Near-Infrared, Prone Position
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: In this study, the aim to assess the combined effects of prone-positioning (PP) and minimal-flow (MF) general anesthesia on regional cerebral oxygenation (RCO) and systemic hemodynamics. Methods: This is a randomized prospective study aiming to evaluate changes in cerebral oxygenation and hemodynamic parameters in MF systemic anesthesia in patients undergoing surgery in PP. Patients were randomized to MF or normal-flow (NF) anesthesia. In the operating room, pulse rate, mean arterial pressure (MAP), peripheral hemoglobin oxygen saturation (spO2), and right-and left-side RCO (assessed by near-infrared spectroscopy, NIRS) were measured perioperatively. Results: Overall, 46 patients were included (24 in the MF group and 22 in the NF group). The amount of anesthetic gas consumption was significantly lower in the low-flow (LF) group. In both groups, the mean pulse rate showed a decrease after PP. Before induction, RCO was significantly higher both at the right-and left-sides in the LF group compared to the NF group. This difference continued throughout the operation on the left-side and disappeared 10 min after intubation on the right-side. On the left side, mean RCO decreased after PP in both groups. Conclusion: MF anesthesia in PP did not reduce cerebral oxygenation compared to NF and was safe in terms of systemic hemodynamics and cerebral oxygenation.