Abstract: Abstract:Objective To observe the variation characteristics of cerebral tissue saturation in the reverse Trendelenburg position during laparoscopic surgery. Method Patients with gastric cancer undergoing laparoscopic surgery were monitored intraoperatively using the FORE-SIGHT cerebral oximeter . Two sensors were placed on the subject's forehead bilaterally for continuous monitoring of SCTO2.The subjects were in the 30°reverse Trendelenburg position during surgery.Datas of SCTO2, PETCO2 ,MAP and Temperature recorded every fifteen minutes after carbon dioxide pneumoperitoneum were analyzed . Meanwhile, concentration of hemoglobin are examinated at preoperation and postoperation. All patients were followed up for neurological complications. Result 20 patients were monitored. The patients’ age ranged from 34 t0 80 yr.The base value of SCTO2 was 72±6% on the left sensor,and 72±4% on the right sensor.The SCTO2 maximum values were 84±5% on the left sensor,and 81±4% on the right sensor after 75 minutes carbon dioxide pneumoperitoneum. During pneumoperitoneum the SCTO2 values increased by 8.31±5.77% on the left sensor ,and 8.21±5.69% on the right sensor. The maximum increasing amplitudes of SCTO2 were 15.49% (left) and 17.14%(right) respectively during CO2 pneumoperitoneum.The PETCO2 values before pneumoperitoneum, 15min and 75min pneumoperitoneum were 33.78±2.33mmHg, 38.44±2.83mmHg and 40.75±2.22mmHg ,respectively. There were no significant difference in datas of MAP,Temperature and hemoglobin concentration.Neurological complications of postoperation were not found.Conclusion The SCTO2 values increased under reverse trendelenburg and carbon dioxide pneumoperitoneum because of the raised FiO2 and cerebral blood flow due to hypercapnia which can contributed to maintain cerebral oxygen supply and demand balance .
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