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Cerebral Oxygenation during Laparoscopic Surgery: Jugular Bulb versus Regional Cerebral Oxygen Saturation

 Seung Ho Choi  ;  Soo Hwan Kim  ;  Sung Jin Lee  ;  Sa Rah Soh  ;  Young Jun Oh 
 YONSEI MEDICAL JOURNAL, Vol.54(1) : 225-230, 2013 
Journal Title
Issue Date
Adult ; Aged ; Anesthesia, General ; Brain/metabolism* ; Carbon Dioxide/chemistry ; Cerebrovascular Circulation ; Head-Down Tilt ; Humans ; Jugular Veins/metabolism* ; Laparoscopy/methods* ; Male ; Middle Aged ; Oxygen/metabolism* ; Pneumoperitoneum, Artificial ; Pressure ; Respiration
Cerebral oxygenation ; jugular bulb oxygen saturation ; laparoscopy ; pneumoperitoneum
PURPOSE: We hypothesized that regional cerebral oxygen saturation (rSO2) could replace jugular bulb oxygen saturation (SjvO2) in the steep Trendelenburg position under pneumoperitoneum. Therefore, we evaluated the relationship between SjvO2 and rSO2 during laparoscopic surgery. MATERIALS AND METHODS: After induction of anesthesia, mechanical ventilation was controlled to increase PaCO2 from 35 to 45 mm Hg in the supine position, and the changes in SjvO2 and rSO2 were measured. Then, after establishment of pneumoperitoneum and Trendelenburg position, ventilation was controlled to maintain a PaCO2 at 35 mm Hg and the CO2 step and measurements were repeated. The changes in SjvO2 (rSO2) -CO2 reactivity were compared in the supine position and Trendelenburg-pneumoperitoneum condition, respectively. RESULTS: There was little correlation between SjvO2 and rSO2 in the supine position (concordance correlation coefficient=0.2819). Bland-Altman plots showed a mean bias of 8.4% with a limit of agreement of 21.6% and -4.7%. SjvO2 and rSO2 were not correlated during Trendelenburg-pneumoperitoneum condition (concordance correlation coefficient=0.3657). Bland-Altman plots showed a mean bias of 10.6% with a limit of agreement of 23.6% and -2.4%. The SjvO2-CO2 reactivity was higher than rSO2-CO2 reactivity in the supine position and Trendelenburg- pneumoperitoneum condition, respectively (0.9 ± 1.1 vs. 0.4 ± 1.2% mm Hg(-1), p=0.04; 1.7 ± 1.3 vs. 0.5 ± 1.1% mm Hg(-1), p<0.001). CONCLUSION: There is little correlation between SjvO2 and rSO2 in the supine position and Trendelenburg-pneumoperitoneum condition during laparoscopic surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Soh, Sa Rah(소사라) ORCID logo https://orcid.org/0000-0001-5022-4617
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Lee, Sung Jin(이성진)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
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