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 ORIGINAL ARTICLE
Year : 2006  |  Volume : 2  |  Issue : 2  |  Page : 67-72

Changes in cerebral oximetry during peritoneal insufflation for laparoscopic procedures


1 Departments of Anesthesiology, University of Missouri, Columbia, Missouri
2 Departments of Pediatrics, University of Missouri, Columbia, Missouri

Correspondence Address:
J D Tobias
Division of Pediatric Anesthesiology, Russell and Mary Shelden Chair in Pediatric Intensive Care Medicine, University of Missouri, Department of Anesthesiology, 3W-27G HSC, One Hospital Drive, Columbia, Missouri - 65212

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.26651

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BACKGROUND: Changes in cardiac output may occur during insufflation for laparoscopic procedures. However, there are limited data regarding its potential effects on cerebral oxygenation. MATERIALS AND METHODS: Cerebral oxygenation (ScO2), end tidal CO2, heart rate, blood pressure and oxygen saturation by pulse oximetry were recorded every 5 minutes prior to insufflation, during insufflation and after desufflation. Minute ventilation was increased to maintain normocapnia and the depth of anesthesia was adjusted or fluids/phenylephrine administered to maintain the blood pressure within 20% of the baseline. RESULTS: The cohort for the study included 70 adults for laparoscopic herniorrhaphy, gastric bypass or cholecystectomy. A total of 1004 ScO2 values were obtained during laparoscopy. The ScO2 decreased from the baseline in 758 of the1004 data points. The ScO2 was 0-9 less than the baseline in 47.8% of the values, 10-19 less than the baseline in 24.9% of the values and 20-29 less than the baseline in 26 values (2.6%). Eighty-two (8.2%) of the values were less than 80% of the baseline value, while 25 values (2.5%) were less than 75% of the baseline value. Twelve patients had at least one ScO2 value that was less than 80% of the baseline and 6 had at least one ScO2 value that was less than 75% of the baseline. Four patients of the cohort had ScO2 values less than 80% of the baseline for more than 50% of the laparoscopic procedure. CONCLUSIONS: Although relatively uncommon, significant changes in cerebral oxygenation do occur in some patients during insufflation for laparoscopic surgery.






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