DSpace About DSpace Software 日本語
 

GINMU >
01 奈良県立医科大学 >
012 大学院 >
0122 学位請求論文 >
01221 博士論文(医学) >
2016年度 >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3330

Title: Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial.
Other Titles: 肺外科手術における術後早期の高次脳機能および術中脳酸素需給バランスに対する麻酔薬の効果 : ランダム化比較試験
Authors: Egawa, Junji
Inoue, Satoki
Nishiwada, Tadashi
Tojo, Takashi
Kimura, Michitaka
Kawaguchi, Takeshi
Taniguchi, Shigeki
Furuya, Hitoshi
Kawaguchi, Masahiko
Issue Date: Oct-2016
Publisher: Springer
Citation: Canadian journal of anaesthesia Vol.63 p.10 p.1161-1169 (2016 Oct)
Abstract: PURPOSE: One-lung ventilation (OLV) may impair cerebral oxygen balance and induce postoperative cognitive dysfunction (POCD). It is unclear whether the type of anesthetic influences the incidence of POCD in patients undergoing OLV. This prospective study compared the incidence of POCD and intraoperative cerebral oxygen desaturation in OLV patients anesthetized with propofol vs sevoflurane during lung surgery. METHODS: There were 148 participants enrolled in this study and randomized equally to either the propofol or the sevoflurane group. Anesthesia was maintained with either propofol or sevoflurane combined in both groups with fentanyl and epidural anesthesia. Regional cerebral oxygen saturation (rSO2), jugular bulb venous oxygen saturation (SjO2), and the incidence of cerebral oxygen desaturation (rSO2 or SjO2 < 50% or rSO2 < 80% of baseline) were measured during anesthesia. Cognitive function was assessed using seven neurocognitive tests two days preoperatively, five days postoperatively (primary outcome), and three months postoperatively. Bivariable and multivariable regression analyses were conducted to identify factors associated with POCD. RESULTS: Rates of POCD did not differ statistically between groups five days postoperatively (propofol, 16/72 patients; sevoflurane, 24/72 patients; RR, 0.67; 95% CI, 0.39 to 1.15; P = 0.14) or three months postoperatively (propofol, 9/60 patients; sevoflurane, 12/58 patients; RR, 0.73; 95% CI, 0.33 to 1.59; P = 0.42). Only three subjects per group showed intraoperative cerebral oxygen desaturation. Multivariable regression analysis revealed older age as an independent predictor of POCD. CONCLUSIONS: No statistically significant difference in the incidence of POCD could be detected between the sevoflurane and propofol anesthesia groups. Postoperative cognitive dysfunction was relatively frequent following OLV in both groups. (REGISTRATION NUMBER: UMIN 000002826).
Description: 博士(医学)・乙第1397号・平成29年3月15日
© Canadian Anesthesiologists' Society 2016
The final publication is available at Springer via http://dx.doi.org/10.1007/s12630-016-0700-4.
発行元が定める登録猶予期間終了の後、本文を登録予定(2017.10)
URI: http://hdl.handle.net/10564/3330
ISSN: 0832610X
Academic Degrees and number: 24601B1397
Degree-granting date: 2017-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2016年度

Files in This Item:

File Description SizeFormat
01_乙1397本文の要旨.pdf乙1397本文の要旨231.78 kBAdobe PDFView/Open
02_乙1397審査要旨.pdf乙1397審査要旨200.38 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

 

Valid XHTML 1.0! DSpace Software Copyright © 2002-2010  Duraspace - Feedback