Mousa Wesam F, Mowafi Hany A, Al-Metwalli Roshdi R, Al-Ghamdi Abdulmohsin A, Al-Gameel Haytham Z
Anesthesiology Department, King Fahd University Hospital, Al Khobar, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2015 Oct;36(10):1199-204. doi: 10.15537/smj.2015.10.12105.
To test the effect of preoperative mannitol infusion on perioperative decreased cerebral oxygen saturation (rSO2) during laparoscopic cholecystectomy.
Forty patients scheduled for laparoscopic cholecystectomy were enrolled in this study conducted at Dammam Hospital of the University, Dammam, Kingdom of Saudi Arabia from December 2013 to June 2014. Patients received either 0.5 g/kg of 20% intravenous mannitol infusion over 10 minutes before induction of anesthesia (group M), or an equal volume of normal saline instead (group C). Primary outcome variable was rSO2. Other variables included extubation time, clinical assessment of consciousness recovery using the Modified Observer's Assessment of Alertness/Sedation Scale (OAA/S), and the mini-mental state examination (MMSE) for cognitive evaluation.
Anesthesia induction increased rSO2 in both groups. Pneumoperitoneum decreased rSO2 in group C, but not in group M. This drop in rSO2 in the group C reached its maximum 30 minutes after extubation, and was significantly less than the preinduction value. Time to extubation in group M was significantly shorter compared with group C (p=0.007). The OAAS in group M at 10 min after extubation was significantly higher compared with group C. No differences were found between the 2 groups in cognitive function as measured by MMSE score.
Preoperative mannitol infusion maintains perioperative rSO2 during laparoscopic cholecystectomy and shortens extubation time with earlier resurgence of OAAS.
测试术前输注甘露醇对腹腔镜胆囊切除术围手术期脑氧饱和度（rSO2）降低的影响。
2013年12月至2014年6月在沙特阿拉伯王国达曼大学达曼医院进行的这项研究纳入了40例计划行腹腔镜胆囊切除术的患者。患者在麻醉诱导前10分钟接受0.5 g/kg的20%静脉甘露醇输注（M组），或等量的生理盐水（C组）。主要结局变量是rSO2。其他变量包括拔管时间、使用改良的观察者警觉/镇静评分量表（OAA/S）进行的意识恢复临床评估以及用于认知评估的简易精神状态检查（MMSE）。
两组麻醉诱导后rSO2均升高。气腹使C组rSO2降低，但M组未降低。C组rSO2的下降在拔管后30分钟达到最大值，且明显低于诱导前值。M组的拔管时间明显短于C组（p = 0.007）。拔管后10分钟M组的OAAS明显高于C组。两组在MMSE评分测量的认知功能方面未发现差异。
术前输注甘露醇可维持腹腔镜胆囊切除术围手术期的rSO2，并缩短拔管时间，使OAAS更早恢复。
