Effect of propofol & sevoflurane on jugular bulb oxygen saturation in patients undergoing brain tumor surgery
Authors: Manoj Kumar Giri, BK Rao, Aman Ohri, LS Mishra
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Introduction: Sevoflurane, and Propofol are widely used for anesthesia during intracranial surgery. All these drugs reduce the cerebral metabolic rate (CMR) for oxygen (CMRO2). In contrast to their similar effect on cerebral metabolism, they have different effects on cerebral blood flow (CBF). Accordingly, the purpose of our study was to determine the jugular bulb venous blood oxygen saturation (SjO2) as a measure of the flow metabolism ratio under propofol & sevoflurane anesthesia in patients with intracranial mass lesions.
Objectives: To compare the effects of Sevoflurane & Propofol on jugular bulb oxygen saturation with the help of evaluation of arterial and jugular bulb venous blood samples for hemoglobin (Hb), hematocrit, and blood gas analysis using automated blood gas analyzer & Calculation of arterial to jugular bulb venous oxygen content differences (AJDO2).
Materials and Method: The proposed study is being carried out in S.R.N. Hospital associated with M.L.N. Medical College, Allahabad after obtaining clearance from the Ethical Comittee. A total of 40 patients were included in the study, of ASA Grade 1 & 2, who after randomisation were divided into 2 groups of 20 each, receiving Propofol & Sevoflurane respectively.
Statistical Test: Data was analysed using unpaired t test with the help of SPSS software.
Results: Propofol when compared with Sevoflurane, decreased Jugular Bulb Oxygen saturation (SjO2) & this difference was statistically significant(49.25±6.57 Vs. 55.60±3.33), decreased PjO2(28.9±2.31 VS 33.15±2.08) & increased AjDO2 (6.62±1.70 VS 5.75±0.81) to a more significant level(p value < 0.05).Further details will be discussed later in the presentation.
Conclusion: In conclusion, brain tumor patients under propofol anesthesia, showed SjO2 and PjO2 levels that were significantly lower than those in patients under Sevoflurane anesthesia. Thus in brain tumour patients, in the already compromised brain tissue it is advisable to use Sevoflurane for maintenance of anaesthesia so as to preserve the flow metabolism ratio.