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Retracted : Haemodynamics and cerebral oxygenation during arthroscopic shoulder surgery in beach chair position under general anaesthesia
Author(s) -
JEONG H.,
LEE S. H.,
JANG E. A.,
CHUNG S. S.,
LEE J.,
YOO K. Y.
Publication year - 2012
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2012.02716.x
Subject(s) - medicine , anesthesia , confidence interval , mean arterial pressure , propofol , supine position , heart rate , remifentanil , odds ratio , general anaesthesia , limits of agreement , surgery , blood pressure , nuclear medicine
Background Patients undergoing surgery in beach chair position ( BCP ) are at risk of cerebral ischaemia. We determined the prevalence and risk factors of jugular venous bulb oxygen desaturation ( SjvO 2 < 50%) in BCP . It was also examined whether regional cerebral tissue oxygen saturation ( SctO 2 ) measured by near‐infrared spectroscopy and SjvO 2 are interchangeable for assessment of cerebral oxygenation. Methods Fifty‐six consecutive patients undergoing arthroscopic shoulder surgery in BCP were studied. Anaesthesia was intravenous with propofol and remifentanil ( P / R ) or inhalational with sevoflurane and 50% nitrous oxide ( S / N ) depending on provider choice. Mean arterial pressure ( MAP ), heart rate ( HR ), SjvO 2 , and SctO 2 were measured before (baseline; post‐induction in supine position) and after the patients assumed BCP . B land– A ltman analysis was performed to measure the agreement between SctO 2 and SjvO 2 . Results SjvO 2 , SctO 2 , MAP , and HR decreased significantly when patients were raised into BCP . Jugular desaturation occurred in 41% of patients (56% with P / R vs. 21% with S / N anaesthesia, P = 0.0077). Risk factors for the desaturation included P / R anaesthesia [adjusted odds ratio ( aOR ) 4.76, 95% confidence interval ( CI ) 1.34–16.95, P = 0.016] and MAP < 50 mmHg ( aOR 3.85, 95% CI 1.21–12.25, P = 0.023). B land– A ltman analysis showed a mean difference of −8.9% with 95% limit of agreement between −40.0% and 23.0%. The percentage error [1.96 standard deviation/mean of the reference method] was 48.5%. Conclusions The incidence of jugular desaturation in BCP was 41%, and P / R anaesthesia and hypotension were associated with its occurrence while undergoing surgery under general anaesthesia. SctO 2 may not replace SjvO 2 for the determination of cerebral oxygenation.