El efecto de diferentes técnicas de anestesia sobre la oxigenación cerebral en cirugía torácica

Abstract

Objective: One-lung ventilation may cause negative changes in the oxygenation of cerebral tissue which results in post-operative cognitive dysfunction. We compared the potential effects of total intravenous anesthesia and inhalation general anesthesia techniques on cerebral tissue oxygenation Materials and methods: In this prospective double-blind trial, patients whose standard anesthesia induction was done were randomly divided into two groups as group total intravenous anesthesia using propofol (Group T, n = 30) and group inhalation general anesthesia using sevoflurane (Group I, n = 30) based on anesthesia maintenance. The intraoperative cerebral oxygen saturation and pre-post-operative mini-mental status test scores of the patients were monitored and recorded. Results: Baseline characteristics were similar between the two groups. The decrease of cerebral oxygen saturation more than 20% in total intravenous anesthesia group was significantly higher than inhalation group (p < 0.05). In both groups, the mini-mental status test values at the post-operative 3 rd h were significantly lower than the preoperative and post-operative 24 th h values (p < 0.05). Conclusions: Inhalation general anesthesia provided better cerebral tissue oxygenation in thoracic surgery with one-lung ventilation compared to total intravenous anesthesia. However, there was no significant correlation between the presence of desaturation and post-operative cognitive dysfunction

Comparison of peripheral blood saturation with brain oxygenation in patients undergoing thoracic surgery

“…Akdogan et al . found that the use of intravenous propofol was correlated with increased risk of BO decrease over 20% as compared to inhalation with sevoflurane (50% vs. 33%, p < 0.05) in patients undergoing thoracic surgery (lobectomies, chest wall resections, pneumonectomies) [ 11 ]. However, Sato et al .…”

“…Type of anesthesia also affects cerebral oxygenation. Akdogan et al found that the use of intravenous propofol was correlated with increased risk of BO decrease over 20% as compared to inhalation with sevoflurane (50% vs. 33%, p < 0.05) in patients undergoing thoracic surgery (lobectomies, chest wall resections, pneu-monectomies) [11]. However, Sato et al in a randomized clinical trial noted that propofol and desflurane induced similar alterations in BO during one-lung ventilation [12].…”

The Association of Cerebral Oxygen Desaturation with Postoperative Cognitive Dysfunction in Older Patients: A Review

“…Neuroinflammation, dysfunction of the cholinergic system, danger-associated molecular patterns, neuronal damage, changes in neurotransmitters and synapses, abnormal β-amyloid function, and abnormalities in the microbial-gut-brain axis are associated with the development of POCD. [28][29][30] Recent studies have shown that decreased cerebral oxygen saturation is a risk factor for POCD. 11,12 Therefore, the relationship between cerebral oxygen levels and POCD has attracted the attention of researchers.…”

“…Several studies have confirmed that a decrease in rSO 2 occurs with OLV during thoracic surgery. 28,60,61 Decreased intraoperative rScO 2 is associated with an increased incidence of early POCD following thoracic surgery. Tang et al conducted a retrospective study and reported that the timing and extent of rScO 2 decline during OLV were associated with early POCD.…”