The effect of esmolol‐induced controlled hypotension in combination with acute normovolemic hemodilution on cerebral oxygenation

Han, Sung‐Hee; Bahk, Jae Hyon; Kim, J.-H.; Lim, Young-Jin; Park, C.-D.; Hwan, Sang; Park, Y.-S.

doi:10.1111/j.1399-6576.2006.01048.x

Cited by 21 publications

(23 citation statements)

References 43 publications

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“…Major orthopedic surgery (hip surgery) reduces rScO 2 ≈10% below baseline, with esmolol induced hypotension, rScO 2 becomes even lower (Han et al, 2006) and also the NIRS-determined deoxygenated hemoglobin (Hb) concentration decreases (Yoshitani et al, 2005). During hip fracture repair rScO 2 <50 or 75% of baseline occurs in 38% of patients (Papadopoulos et al, 2012) and rScO 2 decreases independently of the anesthesia used (propofol vs. sevoflurane; ref.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

Nielsen

2014

Front. Physiol.

124

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Near-infrared spectroscopy (NIRS) is used to monitor regional cerebral oxygenation (rScO2) during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed (i) to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and (ii) to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparoscopic surgery with the patient placed in anti-Tredelenburg's position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery (ICA) also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic, and abdominal surgery the occurrence of postoperative cognitive dysfunction (POCD) might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of rScO2. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.

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Section: Resultsmentioning

confidence: 99%

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

Nielsen

2014

Front. Physiol.

124

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“…The calculations were performed on the first and the third postoperative days using the formula [2] VL (ml) = EBV × ln (Hto/Htmin), in which Hto = initial haematocrit level and Htmin = last haematocrit level. Estimated blood volume (EBV) was calculated using the formulas [7]: EBV (ml)= W × 70 for men or EBV=W × 65 for women, in which W= weight (kg). Blood loss for the third day was not calculated for patients having received blood transfusions.…”

Section: Methodsmentioning

confidence: 99%

Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial

Stučinskas

Tarasevičius

Čebatorius

et al. 2008

International Orthopaedics (SICOT)

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Total knee replacement in severe osteoarthritis usually requires extensive soft tissue releases often associated with considerable bleeding. In a prospective, randomised trial we compared postoperative conventional suction drainage versus four hour clamping drainage in 60 patients undergoing total knee arthroplasty for severe osteoarthritis. We compared blood loss, number of transfusions, postoperative complications and knee function and found significantly less postoperative blood loss through the drains ( p<0.001), and fewer blood transfusions ( p=0.09) were needed in the clamped group. We conclude that clamping drainage after total knee arthroplasty in severe osteoarthritis reduces blood loss through the drains and the need for blood transfusions.Résumé La prothèse totale du genou dans les gonarthroses sévères nécessite souvent une résection tissulaire importante, celle-ci étant souvent associée à un saignement important. Nous avons réalisé une étude prospective randomisée comparant le drainage conventionnel post-opératoire versus clampage du drain durant 4 heures chez 60 patients ayant bénéficié d'une prothèse totale du genou pour une gonarthrose importante. Nous avons comparé les pertes sanguines, le nombre de transfusion, les complications post-opératoires, la fonction du genou. Nous avons observé qu'il y avait beaucoup moins de pertes sanguines dans les drains (p<0.001) et beaucoup moins de transfusions (p=0.009) dans le groupe des patients dont le drain avait été clampé pendant 4 heures. Nous pouvons conclure que le clampage du drain après prothèse totale du genou dans les gonarthroses sévères permet de réduire les pertes sanguines et le nombre de transfusions.

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“…The mean value of rSO 2 was estimated at 65%, based on previous reports. 16,17 To identify a change in rSO 2 value of more than 5% between the Values are mean ± SD. T 0 , after induction of anaesthesia (baseline); T 1 , 10 min after placing in the Trendelenburg position; T 2 , 30 min after the creation of pneumoperitoneum; T 3 , after completion of surgery (patient still under anaesthesia).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Gynaecological Laparoscopic Surgery on Cerebral Oxygenation

Lee

et al. 2006

J Int Med Res

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During gynaecological laparoscopic surgery, alterations in cerebral blood flow and intracranial pressure are frequently reported. These changes affect cerebral perfusion pressure and thus may affect cerebral oxygenation. In this prospective study, the effect of gynaecological laparoscopic surgery on cerebral oxygenation was examined by following the changes in regional cerebral oxygen saturation (rSO 2 ). Twenty-four female patients were enrolled. The mean rSO 2 was 65.5 ± 5.4% at baseline before surgery, 60.8 ± 5.6% when the patient was placed in the Trendelenburg position, 57.1 ± 9.3% after creation of pneumoperitoneum, and 64.0 ± 7.3% after the completion of surgery. During the period of pneumoperitoneum, rSO 2 fell below 50% in two hypercapnic patients. In comparison with baseline, rSO 2 declined significantly in the Trendelenburg position. The creation of pneumoperitoneum itself did not decrease the average rSO 2 value further unless the patients were hypercapnic.

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The effect of esmolol‐induced controlled hypotension in combination with acute normovolemic hemodilution on cerebral oxygenation

Abstract: ANH in combination with esmolol-induced CH causes a significant decrease in cerebral oxygen saturation compared with ANH alone.

Cited by 21 publications

References 43 publications

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial

The Effect of Gynaecological Laparoscopic Surgery on Cerebral Oxygenation

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