Changes of Intraoperative Cerebral Oxygen Saturation and Cerebral Blood Flow Velocity in Shoulder Surgery under Beach Chair Position and Controlled Hypotension and Their Relationship with Postoperative Neurocognitive Function
Changes of Intraoperative Cerebral Oxygen Saturation and Cerebral Blood Flow Velocity in Shoulder Surgery under Beach Chair Position and Controlled Hypotension and Their Relationship with Postoperative Neurocognitive Function
Objective To analyze the changes of cerebral oxygen saturation(rScO2)and cerebral blood flow of patients experiencing shoulder surgery under beach chair position and controlled hypotension,as well as their relationship with postoperative neurocognitive function.Methods A total of 60 patients with Ⅰ or ⅡAmerican Society of Anesthesiologists(ASA)Grades scheduled for shoulder surgery using beach chair position in our hospital were included in the present work.During surgery,the patients took the beach chair position and were treated with intravenous general anesthesia accompanied by a deliberated pressure controlling scheme of hypotension,and measurements of rScO2,cerebral middle artery flow velocity(VMCA)and invasive arterial pressure(at heart level and at auditory meatus level)were performed prior to anesthesia induction,5 min after beach chair positioning,at the beginning of operation,and every 20 min thereafter.Moreover,neurocognitive tests were performed prior to and 24 h after surgery.Results For all the patients,both values of rScO2 and VMCA decreased 5 min after beach chair positioning.Compared to patients without CDEs,there were lower values of arterial pressures at auditory meatus level,rScO2,and VMCA in patients encountered CDEs when turned into beach chair position.Patients with CDEs also acquired worse trial making test results performed 24 h after surgery.The aforementioned inter-group differences were all statistically significant(P＜0.05).Conclusion A part of ASA Ⅰ and Ⅱ patients undergoing shoulder surgery under beach chair position and controlled hypotension exhibit significant decreases in rScO2 and VMCA compared with values before anesthesia and encounter intraoperative CDEs,which consequently impact postoperative neurocognitive function.
维普
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