Background and aims Patients undergoing shoulder arthroscopy in beach chair position are at increased risk for cerebral hypoperfusion and desaturation. The study aim is to compare cerebral oxygenation and incidence of desaturation events between regional with sedation and mixed (general and regional) anaesthesia in patient undergoing shoulder arthroscopy in beach chair position.
Methods 28 patients undergoing shoulder arthroscopy in regional (group I; N =14) or mixed (group II; N=14) anaesthesia were enrolled in this retrospective observational study. Noninvasive near-infrared spectroscopy method was used to measure cerebral oxygenation in both hemispheres. Oxygenation decrease ≥20% from baseline or absolute value <55% for >15 seconds was defined as desaturation event. Heart rate, cerebral oxygenation, peripheral oxygen saturation, noninvasive mean arterial pressure, minimum alveolar concentration (MAC) of sevoflurane, end-tidal CO2 were registered every 5 minutes during operation. Statistical analysis was done using SPSS v.22. This study was approved by the Lithuanian Bioethics Committee.
Results Groups were similar demographically. Mean arterial pressure was higher in group I (83.8±7.5 mmHg vs. 68.9±3.7 mmHg; p=<0.001). Total cerebral oxygenation was lower in group I group (75.1±8.8% vs. 84.2±9.4%; p=<0.001). The incidence of cerebral desaturation was 1.3% in group I and 0.3% in group II.
Conclusions Even with higher mean arterial pressure, cerebral oxygenation was lower in group I, because propofol inhibited spontaneous respiration and oxygen therapy through nasal cannulas did not provide as high cerebral oxygenation as in intubated patients. Nevertheless, both anaesthesia types can be equally safely applied in this type of operations.
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