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Awareness of near-infrared spectroscopy yielded no differences in detecting cerebral desaturation events
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NEW ORLEANS — Results from a randomized, blinded study presented here showed use of near-infrared spectroscopy during arthroscopic shoulder surgery with the patient in the beach-chair position did not provide a better reflection of cerebral oxygenation.
Joseph A. Abboud , MD, and colleagues randomly assigned 41 patients undergoing arthroscopic shoulder surgery in the beach-chair position. Anesthesiologists were either aware or unaware of near-infrared spectroscopy data. Researchers recorded the number of cerebral desaturation events and hypotensive events that required treatment throughout the surgical procedure. Cognitive function was assessed preoperatively, immediately postoperatively and at 2-weeks and 6-weeks postoperatively using the Montreal Cognitive Assessment score.
In his presentation at the American Shoulder and Elbow Surgeons Annual Meeting, Abboud noted no significant differences in baseline vitals and beach-chair vitals between the two groups.
“As far as experience of cerebral desaturation events, we had five in the monitoring-aware group as far as the anesthesiologist being aware and two in the blinded group,” Abboud said. “That was insignificant.”
However, he noted patients in the aware group had a worse subjective bleeding grade vs. patients in the unaware group.
“As far as cognitive function, there was no significant difference at any time point or significant decrease from baseline,” Abboud said.
He added a positive correlation between cerebral tissue oxygenation saturation with systolic blood pressure, diastolic blood pressure and mean arterial pressure. – by Casey Tingle
Reference:
Cox RM, et al. Paper #34. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Oct. 12-14, 2017; New Orleans.
Disclosure: Abboud reports he is a board or committee member for American Shoulder and Elbow Surgeons and Mid-Atlantic Shoulder and Elbow Society; is a paid consultant for DePuy, DJ Orthopaedics, Globus Medical, Integra LifeSciences, MinInvasive, Tornier and Zimmer; receives research support from DePuy, Integra LifeSciences, Tornier and Zimmer; receives IP royalties from DJ Orthopaedics, Globus Medical, Integra LifeSciences, Lippincott and Zimmer; and has stock or stock options with MinInvasive.