Turk J Med Sci. 2017 Dec 19;47(6):1797-1803. doi: 10.3906/sag-1704-159.
Background/aim: This study aimed to evaluate the relationship between the Trendelenburg position and cerebral hypoxia in robot-assisted hysterectomy and prostatectomy.Materials and methods: A standardized mini-mental state examination was administered to 50 patients enrolled in the study 1 h before and after surgery. Near infrared spectroscopy (NIRS) values and hemodynamic and respiratory parameters were recorded after induction of anesthesia (baseline) and once every 20 min in the Trendelenburg position and supine positions. The relationship between the development of cerebral desaturation and the patient's position was examined. Results: For all patients, the baseline mean cerebral oxygen saturation (RSO2) on the right and left were 70.5 ± 7.3% and 70.6 ± 6.7%, respectively. Right RSO2 values at 20 min and 60 min in the Trendelenburg position decreased significantly, but they increased at 120 min. A significant positive correlation was found between right RSO2 and EtCO2 in the supine period following surgery, and between left RSO2 and EtCO2 at 60 min in the Trendelenburg and supine positions. The relationship between NIRS values and cognitive dysfunction was not significant.Conclusion: We found that cerebral saturation decreases as age increases, and cerebral desaturation may occur owing to the Trendelenburg position. There was no correlation between patients? cognitive function and NIRS values.
背景/目的：本研究旨在评估机器人辅助子宫切除术和前列腺切除术时特伦德伦堡体位与脑缺氧之间的关系。
在手术前 1 小时和手术后，对纳入研究的 50 名患者进行标准化的简易精神状态检查。在麻醉诱导后（基线）以及特伦德伦堡体位和仰卧位每隔 20 分钟记录一次近红外光谱（NIRS）值以及血液动力学和呼吸参数。检查脑饱和度下降与患者体位之间的关系。
对于所有患者，右侧和左侧的基线平均脑氧饱和度（RSO2）分别为 70.5±7.3%和 70.6±6.7%。特伦德伦堡体位下 20 分钟和 60 分钟时右侧 RSO2 值显著降低，但 120 分钟时增加。手术后仰卧位时右侧 RSO2 与 EtCO2 之间存在显著正相关，特伦德伦堡和仰卧位时 60 分钟时左侧 RSO2 与 EtCO2 之间也存在显著正相关。NIRS 值与认知功能障碍之间无显著相关性。
我们发现脑饱和度随年龄增长而降低，脑缺氧可能是由于特伦德伦堡体位所致。患者的认知功能与 NIRS 值之间没有相关性。
