Document Detail


The effect of esmolol-induced controlled hypotension in combination with acute normovolemic hemodilution on cerebral oxygenation.
MedLine Citation:
PMID:  16879470     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is possible to perform acute normovolemic hemodilution (ANH) in combination with controlled hypotension (CH). In this randomized prospective study, we examined the effect of the combination of ANH and CH on cerebral oxygenation using near-infrared spectroscopy. METHODS: Fifty-six patients undergoing major orthopedic surgery were randomly assigned to either group A (ANH only) or group CH (CH in combination with ANH). In group CH, CH was induced with esmolol. The regional cerebral oxygen saturation (rSO(2)) was monitored continuously and was compared between the two groups before and after ANH, 30 min (OP(30)) and 90 min (OP(90)) after the beginning of surgery and after the completion of surgery. RESULTS: The value of rSO(2) was the same in both groups in the absence of CH (at baseline: group A, 70.1 +/- 6.0%; group CH, 69.9 +/- 6.7%; after surgery: group A, 64.5 +/- 4.9%; group CH, 64.3 +/- 5.8%). However, in the presence of CH, rSO(2) values were significantly lower in group CH than in group A (at OP(30): group A: 60.4 +/- 3.4%; group CH, 55.9 +/- 7.3%; P < 0.01; at OP(90): group A, 58.3 +/- 5.2%; group CH, 53.5 +/- 6.5%; P < 0.001). The number of patients with rSO(2) < 50% was significantly higher in group CH (14.3%) than in group A (3.8%). CONCLUSION: ANH in combination with esmolol-induced CH causes a significant decrease in cerebral oxygen saturation compared with ANH alone.
Authors:
S-H Han; J-H Bahk; J-H Kim; Y-J Lim; C-D Park; S-H Do; Y-S Park
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  50     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-01     Completed Date:  2006-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  863-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Seoul National University, College of Medicine, 28 Yongon-Dong, Chongro-Gu, Seoul 110-744, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists
Blood Volume*
Brain / metabolism*
Female
Hemodilution*
Humans
Hypotension, Controlled*
Male
Middle Aged
Orthopedic Procedures*
Oxygen Consumption*
Propanolamines / administration & dosage*
Spectroscopy, Near-Infrared
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Propanolamines; 84057-94-3/esmolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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