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Korean J Anesthesiol. 2018 Apr;71(2):127-134. English. Randomized Controlled Trial. https://doi.org/10.4097/kjae.2018.71.2.127
Woo JH , Kim YJ , Jeong JS , Chae JS , Lee YR , Chon JY .
Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea. ankyj@ewha.ac.kr
Department of Anesthesiology and Pain Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract

Background

The beach-chair position (BCP) results in decreases in venous return, cardiac output, and cerebral perfusion pressure. In this randomized, prospective study, we investigated whether applying thigh-high compression stockings affected the maintenance of regional cerebral tissue oxygen saturation (rSO₂) in the BCP.

Methods

Patients undergoing orthopedic surgery in the BCP under general anesthesia were included and assigned randomly to the control or the compression stocking group. Appropriately sized thigh-high compression stockings were applied to the patients in the stockings group. All patients were tilted, up to 45°, throughout the operation. Non-invasive blood pressure, invasive arterial blood pressure zeroed at the external auditory meatus, and rSO₂ were recorded.

Results

Data were analyzed from 19 patients per group. In the BCP, the values of rSO₂ and blood pressure decreased significantly compared with those at baseline, with no significant difference between the groups. The incidences of cerebral desaturation events (CDEs) were similar between the groups; however, that of hypotension was significantly lower in the compression stocking group. During 36 CDEs, the levels of rSO₂ and blood pressure decreased significantly compared with those at baseline in both groups. No significant correlation was found between rSO₂ and blood pressure.

Conclusions

Thigh-high compression stockings reduced the incidence of hypotension but not that of CDEs. Our results suggest that other factors, beyond hypotension itself, contribute to CDEs and in other words, efforts just to reduce the incidence of hypotension may not mainly contribute to a reduction of CDEs occurrence in the BCP under general anesthesia.

Copyright © 2019. Korean Association of Medical Journal Editors.