title: Jugular bulb oxygen saturation under propofol or sevoflurane/nitrous oxide anesthesia during deliberate mild hypothermia in neurosurgical patients.
abstract: Sevoflurane and propofol have been widely used as anesthetic agents for neurosurgery. Recent evidence has suggested that the influence of these anesthetics on cerebral oxygenation may differ. In the present study, the authors investigated jugular bulb oxygen saturation (SjO2) during propofol and sevoflurane/nitrous oxide anesthesia under mildly hypothermic conditions. After institutional approval and informed consent, 20 patients undergoing elective craniotomy were studied. Patients were randomly divided to the group S/N2O (sevoflurane/nitrous oxide/fentanyl anesthesia) or the group P (propofol/fentanyl anesthesia). After induction of anesthesia, the catheter was inserted retrograde into the jugular bulb and SjO2 was analyzed. During the operation, patients were cooled and tympanic membrane temperature was maintained at 34.5 degrees C. SjO2 was measured at normocapnia during mild hypothermia and at hypocapnia during mild hypothermia. There were no statistically significant differences in demographic variables between the groups. During mild hypothermia, SjO2 values were significantly lower in group P than in group S/N2O. The incidence of SjO2 less than 50% under mild hypothermic-hypocapnic conditions was significantly higher in group P than in group S/N2O. These results suggest that hyperventilation should be more cautiously applied during mild hypothermia in patients anesthetized with propofol and fentanyl versus sevoflurane/nitrous oxide/fentanyl.
authors.affiliation: Department of Anesthesiology, Nara Medical Facility, Kashihara, Nara, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Kawano
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Satoki
authors.initials: S
authors.lastname: Inoue
authors.forename: Toshinori
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshitani
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Furuya
authors.forename: Toshisuke
authors.initials: T
authors.lastname: Sakaki
mesh_terms: D000704:Analysis of Variance; D019162:Anesthetics, Combined / Q000494:pharmacology; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D001784:Blood Gas Analysis; D002404:Catheterization; D003399:Craniotomy; D005260:Female; D006801:Humans; D016857:Hypocapnia / Q000097:blood / Q000209:etiology; D007036:Hypothermia, Induced; D007601:Jugular Veins / Q000187:drug effects / Q000502:physiology*; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009609:Nitrous Oxide / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood*; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane
chemical_list: D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D010100:Oxygen; D015742:Propofol