Near-infrared spectroscopy for assessing microcirculation during laparoscopic gynaecological surgery under combined spinal-general anaesthesia or general anaesthesia alone: a randomised controlled trial

AbstractWhile pneumoperitoneum causes negative macrohaemodynamic effects, much less is known about microcirculatory effects of different anaesthetic techniques and laparoscopy. Therefore, we aimed to explore microcirculatory effects of combined spinal –general anaesthesia and laparoscopy, as measured by near-infrared spectroscopy over forearm and calf muscles utilising a 3-min ischemic challenge. Patients (n = 102) undergoing elective laparoscopic gynaecological surgery were randomised to receive general anaesthesia alone or in combination with high-dose or low-dose spinal analgesia (levobupivacaine 7.5 mg or 3.75 mg, respectively, plus sufentanil 2.5 μg). Primary outcomes were near-infrared spectroscopy derived parameters before general anaesthesia induction, 5 min after tracheal intubation, and 15 min after pneumoperitoneum co mmencement. General anaesthesia resulted in impaired post-ischaemic recovery rate in the forearm (p <  0.001, within all groups), which improved during laparoscopy. For the calf, before general anaesthesia induction, high and low dose spinal analgesia significantly slowed the post-ischaemic recovery compared to control (34 ± 16% min−1 and 36  ± 13% min−1 vs. 52  ± 27% min−1, respectively; p  = 0.002 and p = 0.006). General anaesthesia abolished differences between the groups (24 ± 14% min−1 and 25  ± 12% min−1 vs. 27  ± 18% min−1), while during laparoscopy high-dose spinal anal...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research