Qiang Zhipeng,Zhang Jianmin,Zhao Xin,et al.Effect of postural changes on regional cerebral oxygen saturation in children during scoliosis correction surgery[J].Journal of Clinical Pediatric Surgery,,19():125-129,154.[doi:10.3969/j.issn.1671-6353.2020.02.007]
Effect of postural changes on regional cerebral oxygen saturation in children during scoliosis correction surgery
- Keywords:
- Scoliosis; Regional Cerebral Oxygen Saturation; Posture; Child
- CLC:
- R726.8;R682.3;R443+.9
- Abstract:
- Objective To evaluate the effect of postural changes in children with scoliosis correction on regional cerebral oxygen saturation.Methods A total of 44 children undergoing selective scoliosis correction under general anesthesia were recruited.There were 23 boys and 21 girls with an age range of (3-14) years.The ASA grades were Ⅰ-Ⅲ.Continuous monitoring of bilateral regional cerebral oxygen saturation was performed by near-infrared spectroscopy (NIRS) after room entry.The value of rScO2 was recorded before pure oxygen inhalation (T0,baseline),after anesthesia induced intubation (T1),5 min before prone position (T2),5 min after prone position (T3),15 min after prone position (T4),30 min after prone position (T5),45minutes after prone position (T6),60 minutes after prone position (T7),75 min after prone position (T8),90 min after prone position(T9),105 min after prone position (T10) and 120 min after prone position (T11).Arterial blood pressure (ABP),heart rate (HR),pulse oxygen saturation (SpO2) and end tidal carbon dioxide partial pressure (PetCO2) were continuously recorded after radial artery puncture.Results The values of rScO2 of left/right side were lower than those of supine position at each timepoint after prone position.And rScO2 decreased from 81.30% to 74.05% at left side and dropped from 81.52% to 73.86% at right side after 2h of prone position.No significant difference existed in MAP between T3,T4,T5,T6,T7 and T2 (P>0.05).However,significant decreases occurred in T8,T9,T10 and T11 (P<0.05); No significant difference existed in HR,SpO2or PetCO2 between T3-T11 and T2 (P>0.05).Postural changes affected regional cerebral oxygen saturation in children.Within 2 hours from supine to prone position,rScO2 was lower than supine position (P<0.01).Conclusion Regional cerebral oxygen saturation decreases in prone position.Therefore intraoperative prone position should be minimized as much as possible and brain protection should be strengthened for enhancing surgical safety.
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Memo
收稿日期:2019-09-14。
通讯作者:张建敏,Email:zjm428@sina.com