Preoperative mannitol infusion improves perioperative cerebral oxygen saturation and enhances postoperative recovery after laparoscopic cholecystectomy
Preoperative mannitol infusion improves perioperative cerebral oxygen saturation and enhances postoperative recovery after laparoscopic cholecystectomy
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DOI：
10.15537/smj.2015.10.12105
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发表时间：
2015-10-01
影响因子：
1.6
通讯作者：
Al-Gameel, Haytham Z.
中科院分区：
文献类型：
--
作者：
Mousa, Wesam F.;Mowafi, Hany A.;Al-Gameel, Haytham Z.
目的：为了测试术前甘露醇输注对腹腔镜胆囊切除术围手术期脑氧饱和度（rSO（2））降低的影响，方法：40例腹腔镜胆囊切除术患者入选本研究，该研究于2013年12月至2014年6月在沙特阿拉伯王国达曼大学医院达曼进行。麻醉诱导前10 min静脉滴注20%甘露醇0.5 g/kg（M组）或等量生理盐水（C组）。主要结局变量为rSO（2）。其他变量包括拔管时间、使用改良的观察者评估警觉/镇静量表（OAA/S）对意识恢复的临床评估以及用于认知评估的简易精神状态检查（MMSE）。气腹使C组rSO（2）降低，而M组无明显变化。C组rSO（2）的下降在拔管后30分钟达到最大值，明显低于诱导前的值。M组的拔管时间显著短于C组（p=0.007）。M组拔管后10 min的OAAS明显高于C组。两组之间的认知功能无差异，通过MMSE score.Conclusion：术前甘露醇输注维持围手术期rSO（2）在腹腔镜胆囊切除术，缩短拔管时间与早期复苏的OAAS。
Objectives: To test the effect of preoperative mannitol infusion on perioperative decreased cerebral oxygen saturation (rSO(2)) during laparoscopic cholecystectomy.Methods: Forty patients scheduled for laparoscopic cholecystectomy were enrolled in this study conducted at Dammam Hospital of the University, Dammam, Kingdom of Saudi Arabia from December 2013 to June 2014. Patients received either 0.5 g/kg of 20% intravenous mannitol infusion over 10 minutes before induction of anesthesia (group M), or an equal volume of normal saline instead (group C). Primary outcome variable was rSO(2). Other variables included extubation time, clinical assessment of consciousness recovery using the Modified Observer's Assessment of Alertness/Sedation Scale (OAA/S), and the mini-mental state examination (MMSE) for cognitive evaluation.Results: Anesthesia induction increased rSO(2) in both groups. Pneumoperitoneum decreased rSO(2) in group C, but not in group M. This drop in rSO(2) in the group C reached its maximum 30 minutes after extubation, and was significantly less than the preinduction value. Time to extubation in group M was significantly shorter compared to group C (p=0.007). The OAAS in group M at 10 min after extubation was significantly higher compared to group C. No differences were found between the 2 groups in cognitive function as measured by MMSE score.Conclusion: Preoperative mannitol infusion maintains perioperative rSO(2) during laparoscopic cholecystectomy and shortens extubation time with earlier resurgence of OAAS.