Document Detail


Changes in cerebral oximetry during peritoneal insufflation for laparoscopic procedures.
MedLine Citation:
PMID:  21170237     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Changes in cardiac output may occur during insufflation for laparoscopic procedures. However, there are limited data regarding its potential effects on cerebral oxygenation.
MATERIALS AND METHODS: Cerebral oxygenation (ScO(2)), end tidal CO(2), heart rate, blood pressure and oxygen saturation by pulse oximetry were recorded every 5 minutes prior to insufflation, during insufflation and after desufflation. Minute ventilation was increased to maintain normocapnia and the depth of anesthesia was adjusted or fluids/phenylephrine administered to maintain the blood pressure within 20% of the baseline.
RESULTS: The cohort for the study included 70 adults for laparoscopic herniorrhaphy, gastric bypass or cholecystectomy. A total of 1004 ScO(2) values were obtained during laparoscopy. The ScO(2) decreased from the baseline in 758 of the 1004 data points. The ScO(2) was 0-9 less than the baseline in 47.8% of the values, 10-19 less than the baseline in 24.9% of the values and 20-29 less than the baseline in 26 values (2.6%). Eighty-two (8.2%) of the values were less than 80% of the baseline value, while 25 values (2.5%) were less than 75% of the baseline value. Twelve patients had at least one ScO(2) value that was less than 80% of the baseline and 6 had at least one ScO(2) value that was less than 75% of the baseline. Four patients of the cohort had ScO(2) values less than 80% of the baseline for more than 50% of the laparoscopic procedure.
CONCLUSIONS: Although relatively uncommon, significant changes in cerebral oxygenation do occur in some patients during insufflation for laparoscopic surgery.
Authors:
C L Gipson; G A Johnson; R Fisher; A Stewart; G Giles; J O Johnson; J D Tobias
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of minimal access surgery     Volume:  2     ISSN:  0972-9941     ISO Abbreviation:  J Minim Access Surg     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2010-12-20     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101228183     Medline TA:  J Minim Access Surg     Country:  India    
Other Details:
Languages:  eng     Pagination:  67-72     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, University of Missouri, Columbia, Missouri.
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