Effect of therapeutic hypercapnia on balance between cerebral O2supply and demand in patients un-dergoing arthroscopic shoulder surgery in beach chair position
10.3760∕cma.j.issn.0254-1416.2017.10.006
- VernacularTitle:治疗性高碳酸血症对沙滩椅位下肩关节镜手术患者脑氧供需平衡的影响
- Author:
Youmei ZUO
1
;
Jun LI
;
Xinqi CHENG
;
Xuesheng LIU
;
Erwei GU
Author Information
1. 安徽医科大学第一附属医院麻醉科
- Keywords:
Hypercapnia;
Posture;
Brain;
Shoulder joint;
Oxygen consumption
- From:
Chinese Journal of Anesthesiology
2017;37(10):1176-1179
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of therapeutic hypercapnia on the balance between cer-ebral O2supply and demand in the patients undergoing arthroscopic shoulder surgery in the beach chair posi-tion(BCP). Methods Forty-eight patients of both sexes, aged 21-64 yr, weighing 45-80 kg, of Ameri-can Society of Anesthesiologists physical statusⅠorⅡ, scheduled for elective arthroscopic shoulder surgery in the beach chair position, were divided into 2 groups(n=24 each)using a random number table: control group(group C, end-tidal pressure of carbon dioxide 35-40 mmHg)and therapeutic hypercapnia group (group H, end-tidal pressure of carbon dioxide 45-50 mmHg). The regional cerebral oxygen saturation (rSO2)was recorded after induction and before BCP, immediately after BCP, at 3, 6, 9, 12, 15, 18, 21, 24, 27 and 30 min after BCP and at the end of surgery(T0-12). The occurrence of cerebral desaturation events, extubation time, duration of stay in postanesthesia care unit, development of nausea and vomiting and requirement for vasoactive drugs were recorded during surgery. Results Compared with the baseline at T0, the rSO2was significantly decreased at T1-12in group C and at T2-6in group H(P<005). The rSO2was significantly higher at T1-12, and the incidence of cerebral desaturation events was lower in group H than in group C(P<005). There was no significant difference between the two groups in the extubation time, dura-tion of stay in postanesthesia care unit, incidence of nausea and vomiting or requirement for vasoactive drugs (P>005). Conclusion Therapeutic hypercapnia can improve the balance between cerebral O2supply and demand in the patients undergoing arthroscopic shoulder surgery in the BCP.
