AI Article Synopsis
- This study investigates cerebral monitoring in elderly patients undergoing urologic surgery under either propofol or sevoflurane anesthesia, focusing on specific cerebral oximetry parameters.
- A total of 100 patients (70-80 years old) were randomized to receive either propofol or sevoflurane, and changes in cerebral oxygenation were measured at various time points while avoiding surgery-related factors.
- Both anesthesia groups showed significant decreases in the ΔoHbi measurements over time, indicating similar patterns of cerebral oxygenation changes, with no significant differences between the two anesthesia methods.
Article Abstract
Study Objective: Elderly patients undergoing pathophysiological changes necessitate clinical tools for cerebral monitoring. This prospective randomized controlled study aimed to explore how cerebral monitoring using ΔoHbi, ΔHHbi, and ΔcHbi manifests in elderly patients under either propofol or sevoflurane anesthesia.
Design: Single-center, prospective, randomization.
Setting: A single tertiary hospital (Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea).
Patients: Enrolled 100 patients scheduled for urologic surgery under general anesthesia. Inclusion criteria were (a) age 70-80 years, (b) American Society of Anesthesiologists (ASA) physical status I-II.
Intervention: Patients were double-blind randomized to receive propofol-based or sevoflurane anesthesia. Cerebral oximetry-related parameters were measured at 5, 10, 15, 20, and 30 min in a setting devoid of surgery-related factors.
Measurements: The primary outcome focused on the ΔoHbi pattern in the left and right sides within the propofol and sevoflurane groups.
Main Results: We analyzed 100 patients, 50 patients in each group. In the propofol group, the left ΔoHbi decreased from 1.4 (3.7) at 5 min to -0.1 (1.8) at 30 min (P < 0.0001), and the right ΔoHbi decreased from 2.9 (4.2) at 5 min to -0.06 (2.3) at 30 min (P < 0.0001). In the sevoflurane group, the left ΔoHbi decreased from 1.1 (3.4) at 5 min to -1.4 (4.4) at 30 min (P < 0.0001), and the right ΔoHbi decreased from 2.0 (3.2) at 5 min to -1.2 (3.9) at 30 min (P < 0.0001). There were no significant differences between the two groups. ΔHHbi did not exhibit significant changes after an initial decrease at 5 min and showed no significant differences between the two groups.
Conclusions: In cerebral oximetry, ΔoHbi and ΔHHbi could emerge as a valuable approach for discerning changes in the underlying baseline status of the brain in elderly patients during anesthesia.
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| http://dx.doi.org/10.1016/j.jclinane.2024.111519 | DOI Listing |
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