Akçay Lerzan, Soyalp Celaleddin, Yüzkat Nureddin, Gülhaş Nurçin
Department of Anaesthesiology and Reanimation, Health Sciences University Van Training and Research Hospital, Van, Turkey.
Department of Anaesthesiology and Reanimation, Van Yüzüncü Yıl University School of Medicine, Van, Turkey.
Turk J Anaesthesiol Reanim. 2019 Oct;47(5):396-401. doi: 10.5152/TJAR.2019.23911. Epub 2019 May 22.
The commonly performed sitting position with head extended during thyroidectomy has been shown to cause adverse effects on cerebral regional oxygen saturation (CrSO2). Therefore, the present study aimed to investigate the effects of two well-known anaesthetic agents, desflurane and sevoflurane, on CrSO2 in patients undergoing thyroidectomy in the semi-sitting position by near-infra-red spectroscopy monitoring.
The study included 60 patients aged 18-65 years, with an American Society of Anesthesiologists (ASA) physical status classification score I-III, who underwent elective thyroidectomy in the semi-sitting position. The patients were randomly divided into two groups, depending on the anaesthetic agent administered: (1) sevoflurane group (Group S; n=30) and (2) desflurane group (Group D; n=30). After intubation, the patients were placed in a 45-degree semi-sitting position. Vital signs and the CrSO2 levels in both hemispheres were recorded both pre-induction and at the induction minute 1, post-intubation, post-positioning, every 5 minutes intraoperatively and in the case of sudden changes.
No significant difference was found between the groups in terms of age, height, body weight, the ASA score, operative time and left- and right-hemisphere CrSO2 (p>0.05). Moreover, the two groups were statistically similar to each other with regard to peripheral capillary oxygen saturation, heart rate, systolic and diastolic blood pressure, mean artery pressure and end-tidal CO (ETCO) levels.
Desflurane and sevoflurane had similar effects in the preservation of CrSO2 in patients undergoing thyroidectomy in the semi-sitting position.
甲状腺切除术期间常用的头部伸展坐姿已被证明会对脑局部氧饱和度（CrSO2）产生不利影响。因此，本研究旨在通过近红外光谱监测，调查两种知名麻醉剂地氟烷和七氟烷对处于半坐姿接受甲状腺切除术患者的CrSO2的影响。
本研究纳入60例年龄在18至65岁之间、美国麻醉医师协会（ASA）身体状况分级为I - III级、接受半坐姿择期甲状腺切除术的患者。根据所使用的麻醉剂，将患者随机分为两组：（1）七氟烷组（S组；n = 30）和（2）地氟烷组（D组；n = 30）。插管后，将患者置于45度半坐姿。记录诱导前、诱导第1分钟、插管后、体位调整后、术中每5分钟以及出现突然变化时的生命体征和双侧半球的CrSO2水平。
两组在年龄、身高、体重、ASA评分、手术时间以及左右半球CrSO2方面均未发现显著差异（p>0.05）。此外，两组在周围毛细血管血氧饱和度、心率、收缩压和舒张压、平均动脉压以及呼气末二氧化碳（ETCO）水平方面在统计学上彼此相似。
地氟烷和七氟烷在维持处于半坐姿接受甲状腺切除术患者的CrSO2方面具有相似的效果。
