Cerebral oxygenation measured by near-infrared spectroscopy and jugular vein oxygen saturation during robotic-assisted laparoscopic radical prostatectomy under total intravenous anaesthesia

Kumagai, Miho; Ogawa, Shuntaro; Doe, Aya; Suzuki, Kenji

doi:10.1002/rcs.1629

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…We did not observe any significant changes in the tissue oxygen saturation while increase in the IAP. This observation is in a good agreement with reports of other authors [23][24][25][26][27][28][29][30][31] where only small changes (increase or decrease) in the saturation were noted. In 3 out of 8 studies no significant changes in StO2 were reported.…”

Section: Discussionsupporting

confidence: 93%

Influence of intra-abdominal pressure on the amplitude of fluctuations of cerebral hemoglobin concentration in the respiratory band

Sawosz

Kacprzak

Pulawski

et al. 2019

Biomed. Opt. Express

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An intra-abdominal pressure (IAP) is correlated with cerebral perfusion, in a mechanism of reducing venous outflow. The elevated intra-abdominal pressure leads to an increase in the intracranial pressure and a decrease in the cerebral perfusion pressure. We studied the relationship between the IAP and the cerebral oxygenation with the use of the near infrared spectroscopy technique during a gynecological surgery. The changes in hemoglobin concentrations were analyzed in the time-frequency domain in the frequency band related to respiration. The measurements were carried out in 15 subjects who underwent laparoscopic surgery. During the laparoscopy, the intra-abdominal cavity was insufflated with CO2, which caused a controlled increase in the IAP. It was observed that the amplitudes of respirationrelated waves present in hemoglobin concentration signals show an increase of 1.5 to 8.5 times during elevation of the IAP by 15 mmHg.

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Section: Discussionsupporting

confidence: 93%

Influence of intra-abdominal pressure on the amplitude of fluctuations of cerebral hemoglobin concentration in the respiratory band

Sawosz

Kacprzak

Pulawski

et al. 2019

Biomed. Opt. Express

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“…As samples at this level are not contaminated by blood from the external jugular vein, SjvO 2 can accurately reflect the relationship between cerebral oxygen supply and oxygen consumption. 15 The normal baseline value of SjvO 2 is 54% to 75%. 16 Cerebral oxygen supply more than meets cerebral oxygen consumption if its value is more than 75%.…”

Section: Discussionmentioning

confidence: 98%

Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery

Zhu

et al. 2016

Medicine

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The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed.Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P < 0.05). Compared with measurements made following induction of anesthesia, SjvO2 significantly increased with initiation of CPB, ascending aortic occlusion, 20 minutes after initiating CPB, coronary reperfusion, and separation from CPB (P < 0.05). Compared with induction of anesthesia, BIS significantly decreased with the onset of CPB, aortic cross clamping, 20 minutes after initiating CPB, and coronary reperfusion (P < 0.05). Bispectral index increased following separation from CPB. There was no significant change in SvO2 during cardiopulmonary bypass (P > 0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r = 0.687, P = 0.000), with a low linear correlation to temperature (r = 0.453, P = 0.000). Internal jugular bulb venous oxygen saturation was negatively related to temperature (r = −0.689, P = 0.000). Bispectral index was positively related to both temperature (r = 0.824, P = 0.000) and CPP (r = 0.782, P = 0.000). Cerebral oxygen saturation had a positive linear correlation with CPP and a low linear correlation to temperature. Internal jugular bulb venous oxygen saturation had a negative linear correlation to temperature.Pre-and and early postbypass periods are vulnerable times for adequate cerebral oxygenation. Anesthetic management must aim to optimize the supply and demand relationship.

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“…While the data related to the study were recorded by a blinded anesthesia 6 nurse in the anesthesia form, they were also recorded in a separate data collection form. Hypotension was defined as more than 20% decrease in basal MAP [20].…”

Section: Methodsmentioning

confidence: 99%

The effect of different levels of pneumoperitoneum pressures on regional cerebral oxygenation during robotic assisted laparoscopic prostatectomy

Karaveli¹,

Kavakli²,

Küçük³

et al. 2021

Turk J Med Sci

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Background/aim This study aimed to evaluate the effect of low- and high-pressure pneumoperitoneum pressures applied during robotic-assisted laparoscopic prostatectomy (RALP) using near-infrared spectroscopy (NIRS) on regional cerebral oxygenation saturation (rSO 2 ). Materials and methods The prospective, comparative, and observational study included patients aged 18–80 years, with the American Society of Anesthesiologists (ASA) physical status I-II, who would undergo elective RALP. The patients were divided into two groups (12 mmHg of pneumoperitoneum pressure group, n=22 and 15 mmHg of pneumoperitoneum pressure group, n=23). Patients’ demographic data, durations of anesthesia, surgery, pneumoperitoneum, and Trendelenburg position, intraoperative estimated blood loss, fluid therapy, urine output, hemodynamic and respiratory data, and rSO 2 values were recorded at regular intervals. Results The rSO 2 values increased significantly during the pneumoperitoneum combined with steep Trendelenburg position (from t 3 to t 6 ) and at the end of the surgery ( t 7 ) in both groups, compared to the values 5 min after the onset of pneumoperitoneum in the supine position ( t 2 ) (P < 0.05), but no statistical significance was observed between the two groups. No cerebral desaturation was observed in any of our patients. Hemodynamic and respiratory parameters were preserved in both groups. The blood lactate levels were significantly higher in patients operated at high-pressure pneumoperitoneum, compared to those with low-pressure pneumoperitoneum (P < 0.05). Conclusion We believe that low-pressure pneumoperitoneum, especially in robotic surgeries, such as robotic-assisted laparoscopic prostatectomy (RALP), can be applied safely.

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Cerebral oxygenation measured by near-infrared spectroscopy and jugular vein oxygen saturation during robotic-assisted laparoscopic radical prostatectomy under total intravenous anaesthesia

Abstract: These findings suggested that TIVA could be safely used for RALP. It was also demonstrated that rSO did not accurately reflect SjvO during RALP. Copyright © 2014 John Wiley & Sons, Ltd.

Cited by 4 publications

References 22 publications

Influence of intra-abdominal pressure on the amplitude of fluctuations of cerebral hemoglobin concentration in the respiratory band

Influence of intra-abdominal pressure on the amplitude of fluctuations of cerebral hemoglobin concentration in the respiratory band

Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery

The effect of different levels of pneumoperitoneum pressures on regional cerebral oxygenation during robotic assisted laparoscopic prostatectomy

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