PMID- 22421420
OWN - NLM
STAT- MEDLINE
DCOM- 20120619
LR  - 20220408
IS  - 1528-1175 (Electronic)
IS  - 0003-3022 (Linking)
VI  - 116
IP  - 5
DP  - 2012 May
TI  - Cerebral oxygen saturation measured by near-infrared spectroscopy and jugular 
      venous bulb oxygen saturation during arthroscopic shoulder surgery in beach chair 
      position under sevoflurane-nitrous oxide or propofol-remifentanil anesthesia.
PG  - 1047-56
LID - 10.1097/ALN.0b013e31825154d2 [doi]
AB  - BACKGROUND: We examined the effects of different anesthetics on cerebral 
      oxygenation and systemic hemodynamics in patients undergoing surgery in beach 
      chair position (BCP). Jugular venous bulb oxygen saturation (SjvO2) and regional 
      cerebral tissue oxygen saturation (SctO2) were determined while patients were 
      placed from the supine to BCP. Whether SctO2 and SjvO2 are interchangeable in 
      assessing the cerebral oxygenation was also examined. METHODS: Forty patients 
      undergoing shoulder surgery in BCP were randomly assigned to receive 
      sevoflurane-nitrous oxide (S/N) or propofol-remifentanil (P/R) anesthesia. Four 
      patients taking angiotensin II receptor antagonists were excluded post hoc. Mean 
      arterial pressure and heart rate, as well as SjvO2 and SctO2, were measured 
      before (postinduction baseline in supine position) and after BCP. RESULTS: Mean 
      arterial pressure decreased by BCP in both groups. It was, however, significantly 
      higher in S/N (n = 19) than in P/R group (n = 17) at 7 to 8 min after the 
      positioning. SjvO2 also significantly decreased after BCP in both groups, the 
      magnitude of which was lower in S/N than in P/R group (11 +/- 10% vs. 23 +/- 9%, P = 
      0.0006). The incidences of SjvO2 <50% and mean arterial pressure less than 50 
      mmHg were lower in S/N group, but SctO2and the incidence of cerebral desaturation 
      (more than 20% decrease from baseline) did not significantly differ between the 
      groups. SctO2 and SjvO2 were only weakly correlated (beta = 0.218, r2 = 0.133). 
      Bland-Altman analysis showed a mean difference of -7.2% with 95% limit of 
      agreement between -38.2% and 23.8%. CONCLUSIONS: The margin of safety against 
      impaired cerebral oxygenation is greater and SjvO2 is more preserved with S/N 
      than with P/R anesthesia. SctO2 may not be reliable in detecting a low SjvO2 
      during the surgery in BCP.
FAU - Jeong, Hyejin
AU  - Jeong H
AD  - Department of Anesthesiology and Pain Medicine, School of Dentistry, Chonnam 
      National University Medical School, Chonnam, Gwangju, South Korea.
FAU - Jeong, Seongtae
AU  - Jeong S
FAU - Lim, Hoi J
AU  - Lim HJ
FAU - Lee, JongUn
AU  - Lee J
FAU - Yoo, Kyung Y
AU  - Yoo KY
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Anesthesiology
JT  - Anesthesiology
JID - 1300217
RN  - 0 (Anesthetics, Inhalation)
RN  - 0 (Anesthetics, Intravenous)
RN  - 0 (Methyl Ethers)
RN  - 0 (Piperidines)
RN  - 38LVP0K73A (Sevoflurane)
RN  - K50XQU1029 (Nitrous Oxide)
RN  - P10582JYYK (Remifentanil)
RN  - S88TT14065 (Oxygen)
RN  - YI7VU623SF (Propofol)
SB  - IM
CIN - Anesthesiology. 2012 Dec;117(6):1395; author reply 1396. doi: 
      10.1097/ALN.0b013e3182715ba1. PMID: 23168435
MH  - Aged
MH  - *Anesthesia, Inhalation
MH  - *Anesthesia, Intravenous
MH  - *Anesthetics, Inhalation
MH  - *Anesthetics, Intravenous
MH  - *Arthroscopy
MH  - Blood Gas Analysis
MH  - *Brain Chemistry
MH  - Female
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Jugular Veins/*metabolism
MH  - Male
MH  - *Methyl Ethers
MH  - Middle Aged
MH  - *Nitrous Oxide
MH  - Oxygen/*blood
MH  - Oxygen Consumption/*physiology
MH  - *Piperidines
MH  - Posture
MH  - Preanesthetic Medication
MH  - *Propofol
MH  - Remifentanil
MH  - Sample Size
MH  - Sevoflurane
MH  - Shoulder/*surgery
MH  - Spectroscopy, Near-Infrared/*methods
EDAT- 2012/03/17 06:00
MHDA- 2012/06/20 06:00
CRDT- 2012/03/17 06:00
PHST- 2012/03/17 06:00 [entrez]
PHST- 2012/03/17 06:00 [pubmed]
PHST- 2012/06/20 06:00 [medline]
AID - 10.1097/ALN.0b013e31825154d2 [doi]
PST - ppublish
SO  - Anesthesiology. 2012 May;116(5):1047-56. doi: 10.1097/ALN.0b013e31825154d2.