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 Full Text
Anesthesiology,  Clinical Article

Jeong H et al. – The margin of safety against impaired cerebral oxygenation is greater and ugular venous bulb oxygen saturation (SjvO2) is more preserved with sevoflurane–nitrous oxide (S/N) than with P/R anesthesia. SctO2 may not be reliable in detecting a low SjvO2 during the surgery in beach chair position (BCP).

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 8min 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&plismn;10% vs. 23±9%, P=0.0006).
  • The incidences of SjvO2 <50% and mean arterial pressure less than 50mmHg 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 (β=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%.

Please login or register to follow this author.
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Orthopedics

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Orthopedics Articles

1 Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety BMJ, September 9, 2014    Evidence Based Medicine    Clinical Article

2 Role of vitamin D3 in treatment of lumbar disc herniation--pain and sensory aspects: study protocol for a randomized controlled trial Full Text Trials, October 15, 2014    Free full text    Evidence Based Medicine    Clinical Article

3 Vitamin D deficiency is associated with progression of knee osteoarthritis The Journal of Nutrition, October 9, 2014    Clinical Article

4 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 2, 2014    Evidence Based Medicine    Clinical Article

5 A randomized trial of epidural glucocorticoid injections for spinal stenosis New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

6 Effect of percutaneous assisted approach on functional rehabilitation for total hip replacement compared to anterolateral approach: study protocol for a randomized controlled trial Full Text Trials, October 16, 2014    Free full text    Evidence Based Medicine    Clinical Article

7 Alcohol consumption as a preventive factor for developing rheumatoid arthritis: A dose-response meta-analysis of prospective studies Annals of Rheumatic Diseases, October 24, 2014    Evidence Based Medicine    Clinical Article

8 Investigation the efficacy of intra-articular prolotherapy with erythropoietin and dextrose and intra-articular pulsed radiofrequency on pain level reduction and range of motion improvement in primary osteoarthritis of knee Journal of Research in Medical Sciences, September 10, 2014    Clinical Article

9 Clinical investigation for displaced proximal humeral fractures in the elderly: a randomized study of two surgical treatments: reverse total prosthetic replacement versus angular stable plate Philos (The DELPHI-trial) Full Text BMC Musculoskeletal Disorders, October 1, 2014    Free full text    Evidence Based Medicine    Clinical Article

10 Operative versus non-operative treatment for closed, displaced, intra-articular fractures of the calcaneus: randomised controlled trial BMJ, August 1, 2014    Clinical Article

11 Approach to pain management in chronic opioid users undergoing orthopaedic surgery Journal of the American Academy of Orthopedic Surgeons, October 7, 2014    Review Article    Clinical Article

12 Contralateral knee effect on self-reported knee-specific function and global functional assessment - data from the osteoarthritis initiative (OAI) Arthritis Care & Research , October 17, 2014    Clinical Article

13 Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis Canadian Medical Association Journal, October 22, 2014    Evidence Based Medicine    Review Article

14 Efficacy of Canakinumab vs. triamcinolone acetonide according to multiple gouty arthritis-related health outcomes measures International Journal of Clinical Practice, October 21, 2014    Clinical Article

15 Increasing trends and significance of hypovitaminosis D: a population-based study in the Kingdom of Saudi Arabia Archives of Osteoporosis, September 18, 2014    Evidence Based Medicine    Clinical Article

16 Contributions of mood, pain catastrophizing, and cold hyperalgesia in acute and chronic low back pain: A comparison with pain-free controls The Clinical Journal of Pain, October 3, 2014    Clinical Article

17 Research brings new evidence to the 10 year debate on COX-2 pain relief drugs Imperial College London Health News, June 6, 2014

18 Effect of aquatic exercise on ankylosing spondylitis: A randomized controlled trial Rheumatology International, October 28, 2014    Clinical Article

19 Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis Clinical Rheumatology, August 12, 2014    Clinical Article

20 American Academy of Orthopaedic Surgeons releases new guidelines on hip fractures in older adults, ACL injuries, and infant dysplasia of the hip American Academy of Orthopaedic Surgeons News, September 12, 2014

Indexed Journals in Orthopedics: Journal of Bone and Joint Surgery, Journal of Arthroplasty, Spine, The Kneemore