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维生素C输注对糖尿病患者颈动脉内膜切除术全身麻醉期间脑氧饱和度的影响。

Effect of Vitamin C Infusion on Cerebral Oximetry During General Anesthesia for Carotid Endarterectomy in Diabetic Patients.

作者信息

Dahi Mastaneh, Moshari Mohammadreza, Dabir Shideh, Vosoghian Maryam, Tabashi Soodeh, Tavakoli Navid, Madadi Firoozeh

机构信息

Department of Anesthesiology and Critical Care, Anesthesiology Research Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2023 Feb 12;13(1):e134000. doi: 10.5812/aapm-134000. eCollection 2023 Feb.

Abstract

BACKGROUND

There is conflicting information about the effect of vitamin C on brain oxygenation during anesthesia.

OBJECTIVES

The current study was designed and performed to assess the effect of vitamin C infusion and brain oxygenation with cerebral oximetry on improving brain perfusion during general anesthesia in vascular surgery of diabetic patients.

METHODS

This randomized clinical trial was performed on patients candidates for endarterectomy under general anesthesia and referred to Taleghani Hospital in Tehran, Iran, during 2019 - 2020. Considering inclusion criteria, the patients were divided into placebo and intervention groups. The patients in the placebo group received 500 mL of isotonic saline. In the intervention group, the patients received 1 g of vitamin C diluted in 500 mL of isotonic saline by infusion half an hour before anesthesia induction. Patients' oxygen levels were continuously measured by a cerebral oximetry sensor. The patients were put in a supine position for 10 minutes before and after anesthesia. At the end of the surgery, the indicators considered in the study were evaluated.

RESULTS

No considerable difference was observed between systolic and diastolic blood pressure, heart rate, mean arterial pressure, partial pressure of carbon dioxide, oxygen saturation, regional oxygen saturation, supercritical carbon dioxide, and end-tidal carbon dioxide in total and between the two groups in the three stages before and after anesthesia induction and at the end of surgery (P > 0.05). Additionally, there was no significant difference between blood sugar (BS) levels in the study groups (P > 0.05) but in BS levels at three stages before and after anesthesia induction and at the end of the surgery, with a significant difference (P < 0.05).

CONCLUSIONS

The amount of perfusion in the two groups and, therefore, in total at the three stages before and after anesthesia induction and at the end of surgery is not different.

摘要

背景

关于维生素C在麻醉期间对脑氧合的影响,存在相互矛盾的信息。

目的

本研究旨在评估静脉输注维生素C及采用脑氧饱和度测定法监测脑氧合对改善糖尿病患者血管手术全身麻醉期间脑灌注的效果。

方法

本随机临床试验于2019年至2020年在伊朗德黑兰的塔莱加尼医院对接受全身麻醉下行动脉内膜切除术的患者进行。根据纳入标准,将患者分为安慰剂组和干预组。安慰剂组患者接受500毫升等渗盐水。干预组患者在麻醉诱导前半小时静脉输注用500毫升等渗盐水稀释的1克维生素C。通过脑氧饱和度传感器持续测量患者的氧水平。患者在麻醉前后均仰卧10分钟。手术结束时,评估研究中考虑的指标。

结果

在麻醉诱导前后及手术结束时的三个阶段,两组患者的收缩压、舒张压、心率、平均动脉压、二氧化碳分压、氧饱和度、局部氧饱和度、超临界二氧化碳和呼气末二氧化碳总量之间均未观察到显著差异(P>0.05)。此外,研究组之间的血糖(BS)水平无显著差异(P>0.05),但在麻醉诱导前后及手术结束时的三个阶段的血糖水平存在显著差异(P<0.05)。

结论

两组在麻醉诱导前后及手术结束时三个阶段的灌注量,总体上没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb56/10317028/8e2dd4f6812e/aapm-13-1-134000-i001.jpg

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