Background and objectives: The aim of this prospective, observational study was to evaluate changes in regional cerebral oxygen saturation (rSO 2) and incidence of intraoperative cerebral desaturation in a cohort of elderly patients undergoing major abdominal surgery. Methods: rSO2 was continuously monitored on the left and right sides of the forehead in 60 patients older than 65 yr (35 males and 25 females; ASA II-III; age: 72 ± 5 yr; without pre-existing cerebral pathology, and baseline Mini Mental State Examination (MMSE) score >23) undergoing sevoflurane anaesthesia for major abdominal, non-vascular surgery >2 h. Results: Baseline rSO2 was 63 ± 8%; cerebral desaturation (rSO2 decrease <75% of baseline or <80% in case of baseline rSO2 <50%) occurred in 16 patients (26%). The MMSE decreased from 28 ± 1 before surgery to 27 ± 2 on 7th postoperative day (P = 0.05). A decline in cognitive function (decrease in MMSE score ≥ 2 points one week after surgery as compared to baseline value) was observed in six patients without intraoperative cerebral desaturation (13.6%) and six patients who had intraoperative cerebral desaturation (40%) (P = 0.057) (odds ratio: 4.22; CI95%: 1.1-16). Median (range) hospital stay was 14 (5-41) days in patients with an area under the curve of rSO2 <50% (AUCrSO2<50%) >10 min%, and 10 (4-30) days in those with an AUCrSO2 <50% <10 min% (P = 0.0005). Conclusions: In a population of healthy elderly patients, undergoing non-vascular abdominal surgery cerebral desaturation can occur in up to one in every four patients, and the occurrence of cerebral desaturation is associated with a higher incidence of early postoperative cognitive decline and longer hospital stay. © 2006 European Society of Anaesthesiology.

Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: A prospective cohort study / A., Casati; G., Fanelli; Pietropaoli, Paolo; R., Proietti; R., Tufano; S., Montanini; Collaborative Italian Study Group On Anaesthesia In Elderly, Patients; G., Danelli; M., Nuzzi; F., Mentegazzi; G., Torri; C., Martani; E., Spreafico; Fierro, Giovanni; Pugliese, Francesco; G., De Cosmo; P., Aceto; G., Servillo; F., Monaco. - In: EUROPEAN JOURNAL OF ANAESTHESIOLOGY. - ISSN 0265-0215. - STAMPA. - 24:1(2007), pp. 59-65. [10.1017/s0265021506001025]

Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: A prospective cohort study

PIETROPAOLI, Paolo;FIERRO, Giovanni;PUGLIESE, Francesco;
2007

Abstract

Background and objectives: The aim of this prospective, observational study was to evaluate changes in regional cerebral oxygen saturation (rSO 2) and incidence of intraoperative cerebral desaturation in a cohort of elderly patients undergoing major abdominal surgery. Methods: rSO2 was continuously monitored on the left and right sides of the forehead in 60 patients older than 65 yr (35 males and 25 females; ASA II-III; age: 72 ± 5 yr; without pre-existing cerebral pathology, and baseline Mini Mental State Examination (MMSE) score >23) undergoing sevoflurane anaesthesia for major abdominal, non-vascular surgery >2 h. Results: Baseline rSO2 was 63 ± 8%; cerebral desaturation (rSO2 decrease <75% of baseline or <80% in case of baseline rSO2 <50%) occurred in 16 patients (26%). The MMSE decreased from 28 ± 1 before surgery to 27 ± 2 on 7th postoperative day (P = 0.05). A decline in cognitive function (decrease in MMSE score ≥ 2 points one week after surgery as compared to baseline value) was observed in six patients without intraoperative cerebral desaturation (13.6%) and six patients who had intraoperative cerebral desaturation (40%) (P = 0.057) (odds ratio: 4.22; CI95%: 1.1-16). Median (range) hospital stay was 14 (5-41) days in patients with an area under the curve of rSO2 <50% (AUCrSO2<50%) >10 min%, and 10 (4-30) days in those with an AUCrSO2 <50% <10 min% (P = 0.0005). Conclusions: In a population of healthy elderly patients, undergoing non-vascular abdominal surgery cerebral desaturation can occur in up to one in every four patients, and the occurrence of cerebral desaturation is associated with a higher incidence of early postoperative cognitive decline and longer hospital stay. © 2006 European Society of Anaesthesiology.
2007
aged; anaesthesia general; cerbral ischaemia; oximetry; cerebral; postoperative period; cognitive function; surgery abdominal
01 Pubblicazione su rivista::01a Articolo in rivista
Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: A prospective cohort study / A., Casati; G., Fanelli; Pietropaoli, Paolo; R., Proietti; R., Tufano; S., Montanini; Collaborative Italian Study Group On Anaesthesia In Elderly, Patients; G., Danelli; M., Nuzzi; F., Mentegazzi; G., Torri; C., Martani; E., Spreafico; Fierro, Giovanni; Pugliese, Francesco; G., De Cosmo; P., Aceto; G., Servillo; F., Monaco. - In: EUROPEAN JOURNAL OF ANAESTHESIOLOGY. - ISSN 0265-0215. - STAMPA. - 24:1(2007), pp. 59-65. [10.1017/s0265021506001025]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/237055
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