Effects of A-Line Autoregression Index (AAI) Monitoring on Recovery After Sevoflurane Anesthesia for Bariatric Surgery
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ulderico Freo & Michele Carron & Federico Innocente & Mirto Foletto & Donato Nitti & Carlo Ori
- چاپ و سال / کشور: 2010
Description
Monitoring depth of anesthesia may improve anesthetic dosing and postanesthetic recovery in obese patients. Sixty morbidly obese patients undergoing laparoscopic adjustable gastric bandage (LAGB) were randomly assigned to receive anesthesia with sevoflurane titrated by either standard clinical parameters (SCP) (target=baseline hemodynamic parameters±20%) or by A-line ARX index (AAI) (target=20±5). Heart rate, arterial blood pressure, inspiratory and expiratory gas concentrations, and AAI were recorded in all patients at 5-min intervals, but AAI was made available only to the anesthesiologist assigned to AAI-monitored patients. Emergence times in surgery room and recovery times in postanesthesia care unit (PACU) were recorded at 1- and 30-min intervals. Mean intraoperative values of AAI were higher in AAI-monitored than in SCPmonitored patients (22.5 vs 15.0, p=0.001). Compared to SCP monitoring, AAI monitoring reduced consumption of sevoflurane by 20% (p=0.014), times to eye opening by 2.4 min (p=0.001) and to extubation by 2.5 min (p=0.009) and to achieve SpO2 92% in room air by 17 min (p=0.001). Aldrete scores were higher in AAI- than in SCP-monitored patients at arrival in PACU (p=0.035), but Aldrete scores ≥9 were attained in similar times. AAI monitoring can improve titration of and recovery from sevoflurane for LAGB.
OBES SURG (2011) 21:850–857 DOI 10.1007/s11695-010-0150-y Published online: 20 April 2010
