关键词: 局部脑氧饱和度, 腹腔镜手术, 头低位, 麻醉管理

Abstract: Objective To identify the time course of regional cerebral oxygen saturation (rScO2) during laparoscopic gynecological surgery and to quantify the effect of related factors. Methods Data from patients scheduled for elective laparoscopic gynecological surgery were collected and analyzed from June 2017 to Aug 2018 in Peking Union Medical College Hospital. Results Forty-eight ASA 1~2 patients were included. rScO2 presented a U-shaped trend over time with the spline model (P<0.01 for the non-linear association). Episodes of cerebral deoxygenation were observed in 3 patients during the declining period of rScO2. Mean blood pressure, systolic blood pressure and end-tidal CO2 (ETCO2) were positively associated rScO2 (P <0.05). Peak airway pressure (PAP) and body mass index (BMI) were negatively associated rScO2 (P <0.05). Compared with other factors, the effects of BMI and ETCO2 on rScO2 were greater and increased significantly over time(P<0.05). Conclusions During the laparoscopic gynecological surgery with trendelenburg position, rScO2 changed significantly over time. BMI and ETCO2 exhibited greater effects on rScO2, and the effects increased significantly over time.

Key words: Regional cerebral oxygen saturation, laparoscopic surgery, Trendelenburg position, anesthetic management