A comparative analysis of the effects of sevoflurane and propofol on cerebral oxygenation during steep Trendelenburg position and pneumoperitoneum for robotic-assisted laparoscopic prostatectomy

PurposeSteep Trendelenburg position and pneumoperitoneum during robotic-assisted laparoscopic prostatectomy (RALP) increase intracranial pressure (ICP) and may alter cerebral blood flow (CBF) and oxygenation. Volatile anesthetics and propofol have different effects on ICP, CBF, and cerebral metabolic rate and may have different impact on cerebral oxygenation during RALP. In this study, we measured jugular venous bulb oxygenation (SjO2) and regional oxygen saturation (SctO2) in patients undergoing RALP to evaluate cerebral oxygenation and compared the effects of sevoflurane and propofol. We also verified whether SctO2 may be an alternative to SjO2.MethodsFifty patients scheduled for RALP were randomly assigned to undergo sevoflurane (group S) or propofol (group P) anesthesia. SjO2, SctO2, mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), central venous pressure (CVP), partial pressures of arterial oxygen (PaO2) and carbon dioxide (PaCO2), hemoglobin concentration (Hb), Bispectral Index (BIS) and nasopharyngeal temperature (BT) were recorded 5 min before surgery commencement, 5 min after pneumoperitoneum, 5, 30, 60, 90, and 120 min after pneumoperitoneum in a Trendelenburg position, and after desufflation in a supine position.ResultsSjO2 was significantly higher in group S than in group P at all measurement points [group S vs. group P: 77 % (11) vs. 65 % (13), mean of all measurement points (1SD); p < 0.01]. Linear regression analysis (β = 0.106; r2 = 0.065; p = 0.004) shows a weak relationship between SjO2 and SctO2.ConclusionsSevoflurane maintains higher SjO2 levels than propofol during RALP. SctO2 does not accurately reflect SjO2.

• Publication year

  2016

• Venue

  Journal of Anesthesia

• Publication date

  2016-08-26

• Fields of study

  Medicine, Engineering

• Identifiers
  DOI 10.1007/s00540-016-2241-yPMID 27565964PMCID 5097119
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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• Effects of different concentration and duration time of isoflurane on acute and long-term neurocognitive function of young adult C57BL/6 mouse.

  2014influential reference
• Does sevoflurane preserve regional cerebral oxygen saturation measured by near-infrared spectroscopy better than propofol?

  2014cited by this paper
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  2012influential reference
• Effects of sevoflurane and propofol anaesthesia on cerebral oxygenation during normocapnia and mild hypercapnia: a pilot study.

  2012cited by this paper
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  2012cited by this paper
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  2011cited by this paper
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  2008cited by this paper
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  2008influential reference
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  2007cited by this paper
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  2006cited by this paper
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  2005cited by this paper
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  2002cited by this paper
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  2002cited by this paper
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  2001cited by this paper
• Cerebral monitoring: jugular venous oximetry.

  2000cited by this paper
• Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results.

  2000cited by this paper
• Quantitative EEG Correlations with Brain Glucose Metabolic Rate during Anesthesia in Volunteers

  1998cited by this paper
• Evaluation of mechanism of increased intracranial pressure with insufflation

  1998influential reference
• The Influence of Carbon Dioxide and Body Position on Near-Infrared Spectroscopic Assessment of Cerebral Hemoglobin Oxygen Saturation

  1996cited by this paper
• Anesthesia and the Brain: Clinical, Functional, Metabolic and Vascular Correlates

  1989cited by this paper
• Anesthesia and the Brain: Clinical, Functional, Metabolic, and Vascular Correlates

  1988cited by this paper
• Cerebral Blood Volume is Increased in Dogs during Administration of Nitrous Oxide or Isoflurane

  1987influential reference
• [Effect of Disoprivan (propofol) on the circulation and oxygen consumption of the brain and CO2 reactivity of brain vessels in the human].

  1987cited by this paper

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