Application Of Different Inhalation Oxygen Concentration In Laparoscopic Gynecologic Surgery By Cerebral Tissue Oxygen Saturation Monitoring

ObjectiveTo investigate the effects of different oxygen concentrations on cerebral oxygen saturation(SctO2)and Postoperative correlation index in the laparoscopic gynecologic surgery by noninvasive cerebral tissue oxygen saturation(SctO2) monitoring.Reserach methods and main processesSixty patients undergoing elective laparoscpoic gynecologic tumor operation in the hospital were selected as the study subjects and divided into the group A,B andC according to the random number table,20 cases in each group.During anesthesia maintenance,the inhaled oxygen concentration of the group A,B and C were 30%,50%,100%respectively.The invasive mean arterial pressure(iMAP),Heart rate(HR),ECG,oxygen saturation of blood(SpO2),partial pressure of carbon dioxide in end expiratory gas(PetCO2),noninvasive cerebral tissue oxygen saturation(SctO2),Narcotrend(NT)were conventionally monitored.Radial arterial blood was collected for conducting blood gas analysis before anesthesia induction(T-1),before pneumoperitoneum(T0),at 5 minutes(T1),60 minutes(T2),120 minutes(T3)after pneumoperitoneum,and at 5 minutes after pneumoperitoneumclosing(T4).The changes of SctO2,SpO2,iMAP,PaO2,aPH,hemoglobin(HGB),PaCO2,peak inspiratory pressure(PIP),compliance of lung(CL)at the timeof T0?T1?T2?T3?T4 were compared;the oxygenation index(PaO2/FIO2)and intrapulmonary shunt rate(Qs/Qt)at the time of T-1 and T4 were calculated according to the formula;then recorded and compared the MMSE score in preoperative 1 day and postoperative 3 day.We also recorded and compared the extubation time at postoperative awaking,blood loss,urinary production,infusion quantity.ResultsThere is no statistically significant difference of the age,weight,infusion quantity,urinary production,blood loss during operating,anesthetic time,other general vital signsof the patients.Compared with group C,the extubation time at postoperative awaking in the group A and B reduced obviously(P<0.05);and the difference in the extubation time at postoperative awaking had no statistical significance between group A and B(P>0.05).SpO2,iMAP,aPH,PaCO2,HGB,had no statistical difference among different time points(T0,T1,T2,T3,T4,P>0.05);SctO2,PaO2 at different time points in group C were apparently higher than those in the group A and B(P<0.01);SctO2,PaO2 at different time points in group B were apparently higher than those in the group A(P<0.01).SctO2 at different time points during operating was in normal range(60%-90%).There is no statistically significant difference of the PaO2/FIO2 at the time of T-1,T4among 3 gro-ups;There is no statistically significant difference of the Qs/Qt at the time of the T-1;The Qs/Qt at T4 in the group A and group B was significantly lower than that in the group C(P<0.05);The Qs/Qt at the time of T-1 is significantly lower than that at T4(P<0.05).There was no significant difference in PIP and CL between the 3 groups at T0.After laparoscopic inflation,the PIP increased and CL decreased significant at T1,T2,T3,compared with those at T0(P<0.05).The CL at T4 in the three groups increased significantly compared with that at T1,T2,T3;the CL in group A and B increased even more significantly compared with that in group C(P<0.05).The MMSE score in 3 groups had no statistically significant difference between on preoperative 1 day and postoperative 3 day.Main conclusionGenerally,inhaling 30%,50%oxygen concentration of fresh gas during anesthesia maintenance stage is safe and feasible in laparoscopic gynecological tumor operation,moreover has a certain advantages.