Division of Anesthesiology, Department of Anesthesiology, Nihon University School of Medicine, Tokyo, Japan.
Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
Adv Exp Med Biol. 2024;1463:301-306. doi: 10.1007/978-3-031-67458-7_49.
To investigate the effect of the lithotomy position on lower limb circulation under general anaesthesia, near-infrared spectroscopy (NIRS) was used to measure changes in blood volume and oxygenation in thigh tissue in patients (n = 35) under general anaesthesia in the lithotomy position. The NIRS measurement items, including total haemoglobin concentration (total-Hb), tissue haemoglobin index (nTHI), and tissue oxygenation index (TOI) in the thigh, were recorded for 60 min, while the patients were in the lithotomy position. The correlation between changes in each measurement item and patient characteristics, elevation of the lower extremities, and cardiorespiratory indices were evaluated. Data obtained from 24 patients were analysed. The median values (quartile deviation) of changes in total-Hb, nTHI, and TOI during the 60-min period from baseline were + 3.09 (1.99) μmol/L, +0.08 (0.03) a.u., and + 2.25 (1.75) %, respectively, all of which were significantly increased (p < 0.05). Regression analysis showed that no factor was significantly associated with the increase in any measurement item. The present results suggest that circulation in thigh tissue tends to shift towards hyperaemia during 60 min of general anaesthesia in the lithotomy position, regardless of patient background factors or changes in cardiorespiratory conditions.
为了研究全身麻醉下截石位对下肢循环的影响，采用近红外光谱（NIRS）测量全身麻醉下截石位患者（n=35）大腿组织的血液容量和氧合变化。记录 NIRS 测量项目，包括大腿的总血红蛋白浓度（total-Hb）、组织血红蛋白指数（nTHI）和组织氧合指数（TOI），持续 60min。评估每个测量项目的变化与患者特征、下肢抬高和心肺指标之间的相关性。分析了 24 名患者的数据。在从基线开始的 60min 期间，total-Hb、nTHI 和 TOI 的变化中位数（四分位差）分别为+3.09（1.99）μmol/L、+0.08（0.03）a.u.和+2.25（1.75）%，均显著增加（p<0.05）。回归分析显示，没有任何因素与任何测量项目的增加显著相关。本研究结果表明，在全身麻醉下截石位 60min 内，大腿组织的循环倾向于向充血转移，而与患者背景因素或心肺状况的变化无关。
