• J Clin Anesth · Feb 2017

    Randomized Controlled Trial Comparative Study

    Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial.

    • Tomislav Ružman, Tatjana Šimurina, Danijela Gulam, Nataša Ružman, and Maja Miškulin.
    • 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.
    • J Clin Anesth. 2017 Feb 1; 36: 110-117.

    Study ObjectiveTo 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.DesignRandomized, prospective and single-blinded study.SettingAcademic hospital.PatientsASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014.MeasurementsChanges 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 ResultsStudy 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.ConclusionsVIMA 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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