CHEN Yaning, CHENG Jinglin. Influence of regional cerebral oxygenation monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy[J]. Journal of Clinical Medicine in Practice, 2021, 25(2): 32-35,39. DOI: 10.7619/jcmp.20200886
Citation: CHEN Yaning, CHENG Jinglin. Influence of regional cerebral oxygenation monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy[J]. Journal of Clinical Medicine in Practice, 2021, 25(2): 32-35,39. DOI: 10.7619/jcmp.20200886

Influence of regional cerebral oxygenation monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy

More Information
  • Received Date: December 18, 2020
  • Available Online: January 26, 2021
  • Published Date: January 27, 2021
  •   Objective  To explore the influence of regional cerebral oxygenation (rSCO2) monitoring on controlled blood pressure reduction in elderly patients with shoulder arthroscopy.
      Methods  Sixty patients with shoulder arthroscopy were randomly divided into control group and observation group, with 30 cases in each group. The control group was treated with the traditional mode for reducing blood pressure, while the observation group was treated with controlled blood pressure reduction under rSCO2 monitoring. Anesthesia time, operation time, intra-operative fluid infusion and urine volume, intra-operative sodium nitroprusside dosage, postoperative extubation time, Mini Mental State Examination (MMSE) scores before and after anesthesia were compared between the two groups. The hematocrit (HCT) levels of the two groups before and after operation were compared. The incidence of delirium on the 1st, 2nd and 3rd day after operation was compared between the two groups.
      Results  There were no significant differences in operation time, anesthesia time, intra-operative blood loss, intra-operative urine volume and dosage of sodium nitroprusside between the two groups (P>0.05). There was no significant difference in HCT between the two groups before and after operation (P>0.05), but the extubation time of the observation group was significantly earlier than that of the control group (P < 0.05). The ratios of patients with delirium in the observation group on the 1st and 2nd day after operation were significantly lower than that in the control group (P < 0.05). The MMSE scores of the two groups on the 1st and 2nd day after operation were significantly lower than those before anesthesia, but the MMSE scores of the observation group on the 1st and 2nd day after operation were still significantly higher than those of the control group (P < 0.05).
      Conclusion  Controlled blood pressure reduction under the monitoring of rSCO2 can better ensure the stability of cerebral blood flow, shorten the extubation time, reduce the occurrence of delirium, alleviate the damage of cognitive function, and improve the postoperative recovery of patients.
  • [1]
    LI X, EICHINGER J K, HARTSHORN T, et al. A comparison of the lateral decubitus and beach-chair positions for shoulder surgery: advantages and complications[J]. J Am Acad Orthop Surg, 2015, 23(1): 18-28. doi: 10.5435/JAAOS-23-01-18
    [2]
    FRANK R M, SACCOMANNO M F, MCDONALD L S, et al. Outcomes of arthroscopic anterior shoulder instability in the beach chair versus lateral decubitus position: a systematic review and meta-regression analysis[J]. Arthrosc: J Arthrosc Relat Surg, 2014, 30(10): 1349-1365. doi: 10.1016/j.arthro.2014.05.008
    [3]
    陈静霞, 赵昭. 动态监测脑血流及脑氧饱和度对沙滩椅位肩关节镜手术后缺血性脑损伤的影响[J]. 中国医药导报, 2018, 15(4): 82-85. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201804020.htm
    [4]
    AGUIRRE J A, ETZENSPERGER F, BRADA M, et al. The beach chair position for shoulder surgery in intravenous general anesthesia and controlled hypotension: Impact on cerebral oxygenation, cerebral blood flow and neurobehavioral outcome[J]. J Clin Anesth, 2019, 53: 40-48. doi: 10.1016/j.jclinane.2018.09.035
    [5]
    HIGGINS J D, FRANK R M, HAMAMOTO J T, et al. Shoulder arthroscopy in the beach chair position[J]. Arthrosc Tech, 2017, 6(4): e1153-e1158. doi: 10.1016/j.eats.2017.04.002
    [6]
    JACOB M, KALE M N, HASNAIN S. Correlation between cerebral co-oximetry (rSO2) and outcomes in traumatic brain injury cases: a prospective, observational study[J]. Med J Armed Forces India, 2019, 75(2): 190-196. doi: 10.1016/j.mjafi.2018.08.007
    [7]
    BENDAHAN N, NEAL O, ROSS-WHITE A, et al. Relationship between near-infrared spectroscopy-derived cerebral oxygenation and delirium in critically ill patients: a systematic review[J]. J Intensive Care Med, 2019, 34(6): 514-520. doi: 10.1177/0885066618807399
    [8]
    胡裕, 韩阳东, 王宁, 等. 围手术期脑血流灌注的常用监测方法及进展[J]. 医学综述, 2020, 26(9): 1770-1775. doi: 10.3969/j.issn.1006-2084.2020.09.020
    [9]
    冯桂银, 李玲, 樊艳, 等. 沙滩椅体位下行肩关节手术后股外侧皮神经麻痹危险因素分析[J]. 河北医科大学学报, 2020, 41(1): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX202001011.htm
    [10]
    徐杏梅, 陈齐, 李云, 等. 不同血压调控水平对老年患者髋关节置换术中局部脑氧饱和度及术后谵妄的影响[J]. 临床麻醉学杂志, 2019, 35(12): 1161-1165. doi: 10.12089/jca.2019.12.004
    [11]
    刘健慧, 胡佳勇, 杜雪. 围手术期神经认知功能障碍的现状与未来[J]. 同济大学学报: 医学版, 2020, 41(1): 9-18. https://www.cnki.com.cn/Article/CJFDTOTAL-TJIY202001003.htm
    [12]
    FARZANEGAN B, ERAGHI M G, ABDOLLAHI S, et al. Evaluation of cerebral oxygen saturation during hypotensive anesthesia in functional endoscopic sinus surgery[J]. J Anaesthesiol Clin Pharmacol, 2018, 34(4): 503-506. doi: 10.4103/joacp.JOACP_248_17
    [13]
    中华医学会老年医学分会. 老年患者术后谵妄防治中国专家共识[J]. 中华老年医学杂志, 2016, 35(12): 1257-1262. doi: 10.3760/cma.j.issn.0254-9026.2016.12.001
    [14]
    张蔚, 王文祥, 赵伟红, 等. 老年脊柱手术患者血清中H-FABP、B-FABP含量变化与术后认知功能改变的相关性[J]. 临床麻醉学杂志, 2019, 35(4): 380-383. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201904020.htm
    [15]
    WU Z, ZHANG M, ZHANG Z, et al. Ratio of β-amyloid protein (Aβ) and Tau predicts the postoperative cognitive dysfunction on patients undergoing total hip/knee replacement surgery[J]. Exp Ther Med, 2018, 15(1): 878-884. http://europepmc.org/articles/PMC5772777/
    [16]
    KONISHI Y, EVERED L A, SCOTT D A, et al. Postoperative cognitive dysfunction after sevoflurane or propofol general anaesthesia in combination with spinal anaesthesia for hip arthroplasty[J]. Anaesth Intensive Care, 2018, 46(6): 596-600. doi: 10.1177/0310057X1804600610
    [17]
    AL TAYAR A, ABOUELELA A, MOHIUDDEEN K. Can the cerebral regional oxygen saturation be a perfusion parameter in shock[J]. J Crit Care, 2017, 38: 164-167. doi: 10.1016/j.jcrc.2016.11.006
    [18]
    CHAI C, LIU S, FAN L, et al. Reduced deep regional cerebral venous oxygen saturation in hemodialysis patients using quantitative susceptibility mapping[J]. Metab Brain Dis, 2018, 33(1): 313-323. doi: 10.1007/s11011-017-0164-4
    [19]
    吴姗姗, 李锦汶, 梅凤美, 等. 控制性降压对颅内动脉瘤夹闭术中脑氧饱和度和术后神经认知功能的影响[J]. 临床麻醉学杂志, 2019, 35(10): 941-944. doi: 10.12089/jca.2019.10.001
    [20]
    易端, 郭向阳, 郑清. 心脏手术中局部脑氧饱和度与术后认知功能障碍的关系[J]. 中国微创外科杂志, 2016, 16(1): 81-83. doi: 10.3969/j.issn.1009-6604.2016.01.023
    [21]
    吴昊, 张雷, 程新琦, 等. 丙泊酚不同镇静深度对体外循环下心脏瓣膜置换术患者术后谵妄的影响: 与脑氧饱和度的关系[J]. 中华麻醉学杂志, 2017, 37(10): 1163-1166. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYW201410003.htm
  • Related Articles

    [1]YANG Junxia. Effect of rehabilitation nursing intervention on the improvement of quality of life in patients with cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2019, 23(12): 96-98, 102. DOI: 10.7619/jcmp.201912028
    [2]Influence of counterpart nursing on the pain and life quality of patients with gout[J]. Journal of Clinical Medicine in Practice, 2016, (6): 35-38. DOI: 10.7619/jcmp.201606012
    [3]GAO Lini. Effect of nursing intervention on quality of sleep and quality of life in perimenopausal women with insomnia[J]. Journal of Clinical Medicine in Practice, 2015, (18): 78-80. DOI: 10.7619/jcmp.201518025
    [4]FAN Wenxia, XIAO Qiong, ZHOU Ke. Clinical observation on the effect of nursing intervention on psychologyand quality of life in patients with hemodialysis[J]. Journal of Clinical Medicine in Practice, 2015, (14): 36-38. DOI: 10.7619/jcmp.201514012
    [5]YANG Xiaoping, CHEN Qinjie, LI Lina, CHEN Qing. Quality of life in infertile couples and its influencing factors[J]. Journal of Clinical Medicine in Practice, 2015, (10): 71-74. DOI: 10.7619/jcmp.201510022
    [6]XIANG Mei, LIU Aihua. The impact of high quality nursing on adverse emotion and quality of life in patients with colorectal cancer after operation[J]. Journal of Clinical Medicine in Practice, 2015, (6): 62-64. DOI: 10.7619/jcmp.201506020
    [7]WANG Mei, LIU Falan. The influence of self-management guidance on the hope level and life quality in COPD patients[J]. Journal of Clinical Medicine in Practice, 2014, (12): 112-114. DOI: 10.7619/jcmp.201412038
    [8]DING Jiehong. The effect of evidence-based nursing on life quality of gastric ulcer patients[J]. Journal of Clinical Medicine in Practice, 2014, (10): 89-90,93. DOI: 10.7619/jcmp.201410031
    [9]MA Zaihua. Impact of continual nursing intervention on quality of life of patients with stroke[J]. Journal of Clinical Medicine in Practice, 2013, (16): 161-163. DOI: 10.7619/jcmp.201316062
    [10]SONG Wenying. Influence of nursing intervention on the quality of life of patients with depression[J]. Journal of Clinical Medicine in Practice, 2013, (16): 147-149. DOI: 10.7619/jcmp.201316057
  • Cited by

    Periodical cited type(4)

    1. 俞正勇,曹德茂,齐文涛,王小洪,段晓春. 眶上外侧入路治疗急性期破裂大脑中动脉动脉瘤的经验体会. 实用临床医药杂志. 2022(06): 18-22 . 本站查看
    2. 胡海斌. 动脉瘤夹闭术后脑脊液引流与直接缝合硬脑膜对脑积水及脑血管痉挛风险的影响. 中外医学研究. 2019(04): 1-3 .
    3. 计跃,裴本根,张健,张玉华,尹玮,夏雪,孙志翔,杨奎,孙克. 腰大池持续引流在动脉瘤性蛛网膜下腔出血血管内栓塞术后的治疗作用. 安徽医学. 2018(10): 1259-1261 .
    4. 卢国旺. 腰大池持续脑脊液引流术治疗颅脑损伤术后脑脊液漏的临床研究. 中国医学工程. 2017(08): 70-72 .

    Other cited types(1)

Catalog

    Article views (311) PDF downloads (19) Cited by(5)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return