title: Does sevoflurane preserve regional cerebral oxygen saturation measured by near-infrared spectroscopy better than propofol?
abstract: OBJECTIVE
  The aim of this study was to compare the effect of sevoflurane and propofol on cerebral oxygenation, using regional cerebral oxygen saturation (SrO2) measured by near-infrared spectroscopy (NIRS).
  
  
  METHODS
  Prospective, randomized, controlled study.
  
  
  METHODS
  Fifty-four patients aged between 18 and 65 years who underwent elective minor surgery (tumorectomy for breast cancer or inguinal hernia repair) were randomly assigned to receive sevoflurane or propofol anaesthesia. Exclusion criteria included pre-existing cerebrovascular diseases, anaemia, ASA >III, blood loss ≥200 mL, arterial hypotension, baseline pulse oximetry <97%, sign of sensor low quality of SrO2 or bispectral index, and patients with a forehead area <6.5cm. SrO2, bispectral index, haemodynamic data and anaesthetic doses were recorded during surgery.
  
  
  RESULTS
  A total of 48 patients were included in the final analysis (24 in each group). There were no significant differences in mean, minimum and maximum SrO2 between sevoflurane and propofol groups. The relative maximum decrease was higher in propofol anaesthesia than sevoflurane anaesthesia (9.6±10.7 versus 4.2±7.2%; P=0.048). Cerebral desaturation (20% reduction from SrO2 baseline during 15 seconds) occurred in 4 patients in propofol group exclusively (P=0.109). SrO2 adjusted for baseline was higher in the sevoflurane group than in the propofol group (67.3±1.8% versus 64.2±1.7%; P=0.018). There were no significant differences in haemodynamic parameters between the two groups.
  
  
  CONCLUSIONS
  Cerebral cortical oxygenation measured by NIRS may be better preserved with sevoflurane than with propofol. These findings suggest that sevoflurane anaesthesia could be a good option in patients with compromised cerebral oxygenation, given the absence of intracranial hypertension. Further studies with larger sample sizes are required to support our results.
authors.affiliation: Department of Anaesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n., 35010 Las Palmas de Gran Canaria, Spain. Electronic address: ori98es@yahoo.es.
authors.forename: L
authors.initials: L
authors.lastname: Valencia
authors.affiliation: Department of Anaesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n., 35010 Las Palmas de Gran Canaria, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Pérez
authors.affiliation: Department of Anaesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n., 35010 Las Palmas de Gran Canaria, Spain; Department of Anaesthesiology, Hospital el Ángel, Málaga, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Kühlmorgen
authors.affiliation: Department of Anaesthesiology, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n., 35010 Las Palmas de Gran Canaria, Spain; Department of Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: R Y
authors.initials: RY
authors.lastname: Santana
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001923:Brain Chemistry / Q000187:drug effects*; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects*; D015742:Propofol / Q000494:pharmacology*; D000077149:Sevoflurane; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol
keywords: Cerebral oximetry; Cerebral oxygenation; Monitorage; Monitoring; Oxygénation cérébrale; Oxymétrie cérébrale; Propofol; Sevoflurane; Sévoflurane