The intermittent sequential compression device on the lower extremities attenuates the decrease in regional cerebral oxygen saturation during sitting position under sevoflurane anesthesia.
BACKGROUND
The sitting position has potential for serious complications such as cerebral ischemia and venous air embolism. This study investigated the effects of intermittent sequential compression device (SCD) on the changes in regional cerebral oxygen saturation (rSO2) during the sitting position.


METHODS
Sixty-six healthy patients undergoing shoulder arthroscopy in sitting position were randomly assigned to either control (N = 33) or SCD (N = 33) groups. Hemodynamic variables and the rSO2 were measured 5 minutes after the induction of anesthesia (Tsupine, baseline values), and 1, 3, and 5 minutes after raising the patient to a 70-degree sitting position (T1, T3, and T5). The incidence of hypotension was recorded.


RESULTS
The incidence of hypotension was significantly higher in the control group (8/33) than that in the SCD group (1/33) (P = 0.027, odds ratio 0.170, 95% CI 0.042-0.684). The rSO2 was significantly higher in the SCD group compared with those in the control group at T3 and T5. Within the group, rSO2 decreased significantly only in the control group compared with baseline value at T1, T3, and T5. The % change in rSO2 from T0 to T1, T3, and T5 were significantly lower in the SCD group compared to those in the control group.


CONCLUSIONS
The application of SCD to the lower extremities during sitting position under sevoflurane anesthesia was a simple and effective method to attenuate the decrease in cerebral oxygen saturation.
Kwak
Hyun Jeong
HJ
Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University of Medicine and Science, Seoul, South Korea.
Lee
Dongchul
D
Lee
Youn-Woo
YW
Yu
Ga-Yon
GY
Shinn
Helen Ki
HK
Kim
Ji Young
JY
D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D001923:Brain Chemistry / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011187:Posture / Q000502:physiology; D011229:Preanesthetic Medication; D000077149:Sevoflurane; D019265:Spectroscopy, Near-Infrared; D016683:Supine Position / Q000502:physiology
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D010100:Oxygen