Background anaesthetic agents do not influence the impact of arginine vasopressin on haemodynamic states and cerebral oxygenation during shoulder surgery in the beach chair position: a prospective, single-blind study

BMC Anesthesiology

Research Article

Ji-A Song¹  Eun-A Jang¹  Ji Youn Shin¹  Kyung Yeon Yoo¹  Jae Joon Yoon¹  Seongtae Jeong¹ 

[1] Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, 61469, Gwangju, South Korea;

关键词: Anaesthetic;    Arginine vasopressin;    Beach chair position;    Cerebral oxygenation;    Haemodynamics;   

DOI  :  10.1186/s12871-017-0364-9

 received in 2017-01-12, accepted in 2017-05-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAdministration of arginine vasopressin (AVP) is associated with reducing jugular venous (SjvO2) and regional cerebral (rScO2) oxygen saturation under propofol-remifentanil (P/R) anaesthesia. We determined whether background anaesthetics modulate the effect of AVP on cerebral oxygenation and haemodynamics.MethodsWe randomly allocated 60 adult patients scheduled for shoulder surgery in the beach chair position (BCP) into 4 groups, to receive either an intravenous bolus of saline (groups PR-S and SN-S) or 0.05 U/kg AVP (groups PR-AVP and SN-AVP) under P/R or sevoflurane-nitrous oxide (S/N) anaesthesia (n = 15 each). Haemodynamic variables, SjvO2 and rScO2 were measured.ResultsAVP significantly increased mean arterial blood pressure (MAP) and decreased rScO2 in either anaesthetic group. AVP also decreased SjvO2 in the P/R groups but not in the S/N groups. The AVP-treated groups showed higher MAP and cerebral desaturation (>20% rScO2 decrease from baseline), along with lower HR and rScO2 in the BCP than those in the saline-treated groups. In contrast, AVP did not affect SjvO2 values or the incidence of SjvO2 < 50%. Baseline SjvO2 was lower and the magnitude of its reduction in the BCP was greater in the PR-AVP group than in the SN-AVP group, and the lowest SjvO2 values were 37 ± 6 and 57 ± 8%, respectively (P < 0.001).ConclusionsThe choice of anaesthetic regimen did not affect cerebral oxygenation or haemodynamics of AVP in the BCP. However, the negative effect of AVP on cerebral oxygenation should be considered, especially under P/R anaesthesia.Trial registrationClinicalTrials.gov identifier: NCT01687894, registered on September 18, 2012.

【 授权许可】

CC BY   
© The Author(s). 2017