Mannitol improves cerebral oxygen content and postoperative recovery after prolonged retroperitoneal laparoscopy

Zhou, Xiang; Wu, Mingchun; Wang, Yanlin; Song, Xiaofeng; Na-jia, Ling; Yang, Jianwen; Zhang, Dan; Li, Bixi; Tao, Jun

doi:10.1007/s00464-012-2569-9

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…[ 13 , 14 ] Intraoperative use of mannitol has been shown to increase the brain oxygen content in patients undergoing long duration retroperitoneal laparoscopic surgery. [ 15 ] Preoperative use of a small dose of mannitol (0.5 mg/kg) is safe and may relieve side effects, such as electrolyte disturbances, hypotension and renal failure. [ 16 ] Based on our results, the fast intravenous drip of a small dose of mannitol increased the urine volume, reduced SCTO 2 , and increased the brain blood flow, further ameliorating the release of inflammatory mediators, such as histamine and 5-HT, and preventing the occurrence of PONV following gynecological laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients

Guo

Ding²,

Jin³

et al. 2017

Medicine

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Background:The purpose of this study was to investigate effect of cerebral oxygen saturation (SCTO2) on postoperative nausea and vomiting (PONV) in female patients who underwent laparoscopic surgery.Methods:This study included 90 female patients who underwent laparoscopic surgery (60 cases of gynecological operations and 30 cases of gallbladder operations). All patients were allocated into 3 groups of 30 patients each: group A (gynecological laparoscopic surgery), group B (gynecological laparoscopic surgery with mannitol treatment) and group C (laparoscopic cholecystectomy surgery). Perioperative SCTO2, mean blood flow velocity of vertebral artery (VM), vascular resistance index of vertebral artery (RI), and PONV (within 48 hours after surgery) were investigated.Results:No differences in age, body weight, operation time, and hemoglobin levels were observed among the patients (P > .05). The SCTO2 values for groups B and C were lower than those for group A in both brain hemispheres at T4 and T5 (P < .05). The VM was higher in group B than in groups A and C at T3 (P < .05), but differences in VM were not observed between groups B and C at T4 or T5. However, the VM of group A was still lower than the other groups (P < .05), and no difference in VM was observed among the 3 groups at T6 (P > .05). The RI was higher in group C than in groups A and B at T4 (P < .05). The incidence of PONV within 48 hours after surgery was significantly higher in group A than in the other 2 groups (P < .05).Conclusion:Strategies that maintain normal SCTO2 may reduce the incidence of PONV in female patients who underwent laparoscopy surgery by reducing perioperative intracranial pressure.

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Section: Discussionmentioning

confidence: 99%

Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients

Guo

Ding²,

Jin³

et al. 2017

Medicine

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“…Mannitol infusion lowers ICP via creating an osmotic gradient between plasma and brain tissue, drawing water from the cerebral extracellular space into the vasculature. 22 Zhou et al 23 suggested the use of mannitol to increase the cerebral oxygen content after prolonged retroperitoneal laparoscopy. However, in their study, cerebral oxygen balance was evaluated through blood gas analysis of samples obtained from the jugular bulb and the radial artery, and mannitol was administered 150 minutes after abdominal insufflation.…”

Section: Discussionmentioning

confidence: 99%

Preoperative mannitol infusion improves perioperative cerebral oxygen saturation and enhances postoperative recovery after laparoscopic cholecystectomy

Mousa

Mowafi

Al-Metwalli

et al. 2015

SMJ

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Objectives:To test the effect of preoperative mannitol infusion on perioperative decreased cerebral oxygen saturation (rSO2) during laparoscopic cholecystectomy.Methods:Forty patients scheduled for laparoscopic cholecystectomy were enrolled in this study conducted at Dammam Hospital of the University, Dammam, Kingdom of Saudi Arabia from December 2013 to June 2014. Patients received either 0.5 g/kg of 20% intravenous mannitol infusion over 10 minutes before induction of anesthesia (group M), or an equal volume of normal saline instead (group C). Primary outcome variable was rSO2. Other variables included extubation time, clinical assessment of consciousness recovery using the Modified Observer’s Assessment of Alertness/Sedation Scale (OAA/S), and the mini-mental state examination (MMSE) for cognitive evaluation.Results:Anesthesia induction increased rSO2 in both groups. Pneumoperitoneum decreased rSO2 in group C, but not in group M. This drop in rSO2 in the group C reached its maximum 30 minutes after extubation, and was significantly less than the preinduction value. Time to extubation in group M was significantly shorter compared to group C (p=0.007). The OAAS in group M at 10 min after extubation was significantly higher compared to group C. No differences were found between the 2 groups in cognitive function as measured by MMSE score.Conclusion:Preoperative mannitol infusion maintains perioperative rSO2 during laparoscopic cholecystectomy and shortens extubation time with earlier resurgence of OAAS.

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“…Furthermore, the 20° reverse-Trendelenburg position has been reported to decrease the concentration of cerebral oxy-hemoglobin and total hemoglobin during laparoscopic cholecystectomy [ 4 ]. In addition, such changes in intracranial pressure, cerebral perfusion, and oxygenation lead to longer recovery and impaired cognitive function [ 5 ]. In this study, we hypothesized that there might be a changes in regional cerebral oxygen saturation (rSO 2 ) during laparoscopic gastrectomy and subsequent changes in postoperative cognitive function as compared with conventional open gastrectomy.…”

Section: Introductionmentioning

confidence: 99%

Changes in cerebral oxygen saturation and early postoperative cognitive function after laparoscopic gastrectomy: a comparison with conventional open surgery

Kim

Lee

et al. 2016

Korean J Anesthesiol

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BackgroundLaparoscopic gastrectomy requires a reverse-Trendelenburg position and prolonged pneumoperitoneum and it could cause significant changes in cerebral homeostasis and lead to cognitive dysfunction. We compared changes in regional cerebral oxygen saturation (rSO2), early postoperative cognitive function and hemodynamic variables in patients undergoing laparoscopic gastrectomy with those patients that underwent conventional open gastrectomy.MethodsSixty patients were enrolled in this study and the patients were distributed to receive either laparoscopic gastrectomy (laparoscopy group, n = 30) or open conventional gastrectomy (open group, n = 30). rSO2, end-tidal carbon dioxide tension, hemodynamic variables and arterial blood gas analysis were monitored during the operation. The enrolled patients underwent the mini-mental state examination 1 day before and 5 days after surgery for evaluation of early postoperative cognitive function.ResultsCompared to baseline value, rSO2 and end-tidal carbon dioxide tension increased significantly in the laparoscopy group after pneumoperitoneum, whereas no change was observed in the open group. No patient experienced cerebral oxygen desaturation or postoperative cognitive dysfunction. Changes in mean arterial pressure over time were significantly different between the groups (P < 0.001).ConclusionsBoth laparoscopic and open gastrectomy did not induce cerebral desaturation or early postoperative cognitive dysfunction in patients under desflurane anesthesia. However, rSO2 values during surgery favoured laparoscopic surgery, which was possibly related to increased cerebral blood flow due to increased carbon dioxide tension and the effect of a reverse Trendelenburg position.

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Mannitol improves cerebral oxygen content and postoperative recovery after prolonged retroperitoneal laparoscopy

Abstract: After prolonged retroperitoneal laparoscopy, there is an imbalance between oxygen supply and demand. A small dose of mannitol can effectively improve cerebral oxygen metabolism, recovery, and cognitive function after the operation.

Cited by 9 publications

References 33 publications

Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients

Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients

Preoperative mannitol infusion improves perioperative cerebral oxygen saturation and enhances postoperative recovery after laparoscopic cholecystectomy

Changes in cerebral oxygen saturation and early postoperative cognitive function after laparoscopic gastrectomy: a comparison with conventional open surgery

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