Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial.
OBJECTIVE
To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy.


METHODS
Randomized, prospective and single-blinded study.


METHODS
Academic hospital.


METHODS
ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014.


METHODS
Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo2), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtCo2), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia.


RESULTS
Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo2values. Statistically higher rSco2values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo2, TrtCo2, Tpost, Trec30 and Trec60 and incidence of critical rcSo2decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications.


CONCLUSIONS
VIMA technique provides significantly (4%-11%) higher rcSO2values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2decreases.
Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Osijek, J. Huttlera 4, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia; Our Lady of Lourdes Hospital Drogheda, Boyle O'Reilly Terrace, Drogheda, Co Louth, Ireland.
Tomislav
T
Ružman
Department of Anesthesiology and ICU, General Hospital Zadar, Bože Peričića 5, Zadar,Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia; Department of Health Study, University of Zadar, Mihovila Pavlinovića 1, Zadar, Croatia. Electronic address: tatjana.simurina@gmail.com.
Tatjana
T
Šimurina
Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Osijek, J. Huttlera 4, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia.
Danijela
D
Gulam
Institute of Public Health for Osijek-Baranya County, Franje Krežme 1, Osijek, Croatia; Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia.
Nataša
N
Ružman
Faculty of Medicine, University of Osijek, Cara Hadrijana 10, Osijek, Croatia.
Maja
M
Miškulin
D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000187:drug effects; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077149:Sevoflurane; D016037:Single-Blind Method; D019265:Spectroscopy, Near-Infrared; D055815:Young Adult
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D010100:Oxygen; D015742:Propofol
Brain hypoxia; Cholecystectomy; Laparoscopic; Near infrared; Propofol; Sevoflurane; Spectroscopy