Comparison of regional cerebral oxygen saturation variations between sevoflurane and propofol anaesthesia in gynecological laparoscopic surgery

Abstract

Background: Measurement of regional cerebral oxygen saturation (rSO 2) is a safe, noninvasive, and portable optical method that can be used to monitor activity within the cortical areas of the human brain. Making use of specific wavelengths of light, near-infrared spectroscopy (NIRS) provides measurements of oxygenated hemoglobin (Hb) and deoxygenated Hb that is in direct relation with hemodynamic changes in the brain. Aim: The aim of this study was to compare the changes in rSO 2 at different time points between propofol and sevoflurane anesthesia during gynecological laparoscopic surgery. After approval by the institutional ethics committee, written informed consent was taken from all eligible patients. Methods: This randomized clinical study was conducted in a gynecology operation theater complex. Thirty-four patients aged between 18 and 60 years categorized between the American Society of Anesthesiologists (ASA) class I I and II who are scheduled for gynecological laparoscopic surgery under general anesthesia were randomized into two groups with 17 patients in each group. The Group 1 patients receive sevoflurane anesthesia and Group 2 patients receive total intravenous anesthesia using an infusion of propofol. The rSO 2 values were continuously monitored using NIRS. The bispectral index target range during maintenance was 40-50. Results: The sevoflurane group showed significantly higher rSO 2 values than the propofol group in gynecological laparoscopic surgery. Conclusion: It can be inferred that the sevoflurane group showed significantly higher rSO 2 values than the propofol group in gynecological laparoscopic surgery not only during pneumoperitoneum in the Trendelenburg position but also after desufflation of the abdomen in the neutral position (supine).