title: The effects of general vs spinal anesthesia on frontal cerebral oxygen saturation in geriatric patients undergoing emergency surgical fixation of the neck of femur.
abstract: OBJECTIVE
  To assess the effect of regional vs general anesthesia on transcranial cerebral oxygen saturation (rSo2).
  
  
  METHODS
  Prospective, randomized, open-label study.
  
  
  METHODS
  Large referral hospital.
  
  
  METHODS
  Sixty American Society of Anesthesiologists physical status I, II, and III geriatric patients at least 60 years of age, undergoing surgical fixation of the neck of femur.
  
  
  METHODS
  Patients were randomized to receive either general (group GA) or spinal (group S) anesthesia. In all cases, frontal rSo2 was measured for a 10-minute preoperative control period, throughout the surgical procedure, and for 10 minutes postoperatively.
  
  
  RESULTS
  The frequency of a decrease in rSo2 below baseline preoperative levels was significantly (P < .0001) higher in group S. However, the number of patients in whom at least one dip below baseline was recorded was similar between the groups. By contrast, general anesthesia was associated with a significantly higher rSo2 when compared with spinal anesthesia. Logistic regression revealed no correlation between changes in blood pressure, heart rate, or peripheral oxygen saturation and the frequency of rSo2 dips below baseline.
  
  
  CONCLUSIONS
  Cerebral oxygen saturation is likely patient specific and independent of the anesthetic technique administered. Spinal anesthesia is associated with a higher incidence of cerebral desaturation. However, the number of patients in whom at least one dip below baseline was recorded was similar between the groups.
authors.affiliation: Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba 44281, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Hoppenstein
authors.forename: Edna
authors.initials: E
authors.lastname: Zohar
authors.forename: Erez
authors.initials: E
authors.lastname: Ramaty
authors.forename: Shay
authors.initials: S
authors.lastname: Shabat
authors.forename: Brian
authors.initials: B
authors.lastname: Fredman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D001794:Blood Pressure / Q000502:physiology; D004632:Emergency Medical Services; D005260:Female; D005272:Femur Neck / Q000601:surgery*; D005592:Fracture Fixation; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011446:Prospective Studies