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RESEARCH PRODUCT

Cerebral oxygen saturation and cardiac output during anaesthesia in sitting position for neurosurgical procedures: a prospective observational study.

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Abstract Background Neurosurgical operations in the dorsal cranium often require the patient to be positioned in a sitting position. This can be associated with decreased cardiac output and cerebral hypoperfusion, and possibly, inadequate cerebral oxygenation. In the present study, cerebral oxygen saturation was measured during neurosurgery in the sitting position and correlated with cardiac output. Methods Perioperative cerebral oxygen saturation was measured continuously with two different monitors, INVOS® and FORE-SIGHT®. Cardiac output was measured at eight predefined time points using transoesophageal echocardiography. Results Forty patients were enrolled, but only 35 (20 female) were eventually operated on in the sitting position. At the first time point, the regional cerebral oxygen saturation measured with INVOS® was 70 (sd 9)%; thereafter, it increased by 0.0187% min−1 (P Conclusions During neurosurgery in the sitting position, the cerebral oxygen saturation slowly increases and, therefore, this position seems to be safe with regard to cerebral oxygen saturation. Cerebral oxygen saturation is stable because of constant CO and MAP, while the influence of CO on cerebral oxygen saturation seems to be more relevant. Clinical trial registration NCT01275898.