The Effect of Ventilation on Cerebral Oxygenation in the Sitting Position
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cerebral Ischemia
- Sponsor
- NorthShore University HealthSystem
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Incidence of Cerebral Desaturation Events
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The aim of this clinical investigation is to determine the effect of intraoperative ventilation on cerebral oxygen saturation in patients undergoing arthroscopic shoulder surgery in the beach chair position (BCP)
Detailed Description
Recent developments in near-infrared spectroscopy technology now permit rapid assessment of cerebral oxygenation (SctO2) using non-invasive probes. A high incidence cerebral desaturation events (CDE-defined as a decrease in SctO2 values below 20% of baseline measures or absolute SctO2 values ≤ 55 for ≥ 15 seconds) have been observed in previous investigation of patients undergoing shoulder surgery in BCP with hyperventilation. The investigators hypothesize that the incidence of CDE will be reduced in patients ventilated at normocapnic levels (end-tidal carbon dioxide values (ETCO2) of 40-42 mm Hg) when compared to subjects hyperventilated (ETCO2 of 30-32 mm Hg) in the operating room. Patients undergoing shoulder surgery in the BCP will be randomized to a hypocapnic group (ETCO2 of 30-32 mm Hg) or a normocapnic group (ETCO2 of 40-42 mm Hg). Cerebral oxygenation will be measured continuously throughout the procedure to assess perioperative SctO2 values and the incidence of CDE. The investigators previously observed an association between CDE in the operating room and postoperative nausea and vomiting. Therefore, the effect of ventilatory pattern and intraoperative SctO2 on clinical recovery will also be determined.
Investigators
Glenn Murphy
Director, Cardiac Anesthesia and Clinical Research
NorthShore University HealthSystem
Eligibility Criteria
Inclusion Criteria
- •Patients presenting for elective shoulder arthroscopy under general anesthesia in the BCP.
Exclusion Criteria
- •Exclusion criteria include 1) history of pre-existing cerebrovascular disease or orthostatic hypotension 2) age \< 18 years 3) American Society of Anesthesiologists Physical Status IV or V.
Outcomes
Primary Outcomes
Incidence of Cerebral Desaturation Events
Time Frame: Intraoperative-first 2 hours
Cerebral desaturation events were measured with near-infrared spectroscopy
Secondary Outcomes
- Number of Patients Experiencing Nausea and Vomiting(Postanesthesia care unit-first 2 hours)
- Postanesthesia Care Unit Length of Stay (Total Time)(Approximately 5 hours)