Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 16, Pages -Publisher
MDPI
DOI: 10.3390/jcm11164878
Keywords
general anesthesia; cerebral tissue oxygen saturation; near-infrared spectroscopy; emergence
Categories
Funding
- National Natural Science Foundation of China [82071249, 81771207]
- Hunan Medical Association [HMA202101001]
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The increase in cerebral tissue oxygen saturation (SctO(2)) is associated with the emergence from propofol-remifentanil anesthesia, indicating its potential as an indicator of awakening.
Anesthesia emergence is accompanied by changes in cerebral circulation. It is unknown whether cerebral tissue oxygen saturation (SctO(2)) could be an indicator of emergence. Changes in SctO(2), bispectral index (BIS), mean arterial pressure (MAP), and heart rate (HR) were evaluated during the emergence from propofol-remifentanil anesthesia. At the time of cessation of anesthetic delivery, SctO(2), BIS, MAP, and HR values were recorded as baseline. The changes of these parameters from the baseline were recorded as Delta SctO(2), Delta BIS, Delta MAP, and Delta HR. The behavioral signs (body movement, coughing, or eye opening) and response to commands (indicating regaining of consciousness) were used to define emergence states. Prediction probability (Pk) was used to examine the accuracy of SctO(2), BIS, MAP, and HR as indicators of emergence. SctO(2) showed an abrupt and distinctive increase when appearing behavioral signs. BIS, MAP, and HR, also increased but with a large inter-individual variability. Pk value of Delta SctO(2) was 0.97 to predict the appearance behavioral signs from 2 min before that, which was much higher than the Pk values of Delta BIS (0.81), Delta MAP (0.71) and Delta HR (0.87). The regaining of consciousness was associated with a further increase in the SctO(2) value.
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