The effects of general vs spinal anesthesia on frontal cerebral oxygen saturation in geriatric patients undergoing emergency surgical fixation of the neck of femur.
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.
Hoppenstein
David
D
Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba 44281, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Zohar
Edna
E
Ramaty
Erez
E
Shabat
Shay
S
Fredman
Brian
B
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