Key result
Age >65 years and body mass index >30 kg/m2 were associated with a significantly higher decrease in regional cerebral saturation during laparoscopic cholecystectomy (P<0.05).
Why the study?
Does transcranial cerebral oxymetric monitoring identify brain hypoxia in obese and elderly patients undergoing general anesthesia for laparoscopic cholecystectomy?
Observational (n=62)
Does transcranial cerebral oxymetric monitoring identify brain hypoxia in obese and elderly patients undergoing general anesthesia for laparoscopic cholecystectomy?
p-value: p=<0.05
Cerebral oxymetric monitoring identifies significant perioperative cerebral desaturation in elderly and obese patients undergoing laparoscopic cholecystectomy.
Cerebral desaturation may occur more often in elderly and obese patients during laparoscopic cholecystectomy; leaves open whether routine rSO2 monitoring improves outcomes.
The aims of this prospective, observational study were to evaluate the changes of the regional cerebral saturation (rSO2) measured by near-infrared spectroscopy during elective laparoscopic cholecystectomy under total intravenous anesthesia and the association between patient's characteristics and critical decline of rSO2. Hemodynamics, rSO2, and oxygen saturation were recorded in different time points: before the anesthesia (Tbas), 2 minutes after the induction (supine position) (Tind), 2 minutes after CO2 insufflation (supine) (TCO2), 10 minutes after CO2 insufflation (reverse Trendelenburg) (TrevT), and 2 minutes after deflation (supine) (Tpost). Average age was 53±13 (range: 22 to 79 y). In 12 of a total of 62 patients (19.4%) the rSO2 decreased >20% (20.5% to 28.4%) in TCO2 or TrevT times. Significantly higher decrease of the rSO2 was found in patients older than 65 years and those with body mass index >30 kg/m (P<0.05). Noninvasive monitoring of cerebral oxygenation could be an important part of perioperative care in obese and older patients.
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Ružman et al. (2017) conducted an observational in elective laparoscopic cholecystectomy (n=62). Age >65 years and body mass index >30 kg/m2 was evaluated on decrease of regional cerebral saturation (rSO2) >20% (p=<0.05). Age >65 years and body mass index >30 kg/m2 were associated with a significantly higher decrease in regional cerebral saturation during laparoscopic cholecystectomy (P<0.05).
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