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Vasopressin ameliorates hypotension induced by beach chair positioning in a dose-dependent manner in patients undergoing arthroscopic shoulder surgery under general anesthesia
- Source :
- Korean Journal of Anesthesiology, Korean Journal of Anesthesiology, Vol 68, Iss 3, Pp 232-240 (2015)
- Publication Year :
- 2015
- Publisher :
- The Korean Society of Anesthesiologists, 2015.
-
Abstract
- Background The beach chair position (BCP) is associated with hypotension that may lead to cerebral ischemia. Arginine vasopressin (AVP), a potent vasoconstrictor, has been shown to prevent hypotension in BCP. It also improves cerebral oxygenation in different animal models. The present study examined the effect of escalating doses of AVP on systemic hemodynamics and cerebral oxygenation during surgery in BCP under general anesthesia. Methods Sixty patients undergoing arthroscopic shoulder surgery in BCP under general anesthesia were randomly allocated to receive either saline (control, n = 15) or three different doses of AVP (0.025, 0.05, or 0.075 U/kg; n = 15 each) 2 minutes before BCP. Mean arterial pressure (MAP), heart rate (HR), regional cerebral oxygen saturation (SctO2), and jugular venous oxygen saturation (SjvO2) were measured after induction of anesthesia and before (presitting in supine position) and after BCP. Results AVP per se given before BCP increased MAP, and decreased SjvO2, SctO2, and HR in all patients (P < 0.05 for all). BCP decreased MAP, the magnitude of which and hence the incidence of hypotension was decreased by AVP in a dose-dependent manner. While in BCP, every dose of AVP reduced the HR and SctO2. Accordingly, it increased the incidence of cerebral desaturation (> 20% SctO2 decrease from the baseline value) with no differences in SjvO2 and the incidence of SjvO2 < 50% or SjvO2 < 40% among the groups. Conclusions AVP ameliorates hypotension associated with BCP in a dose-dependent manner in patients undergoing shoulder surgery under general anesthesia. However, AVP may have negative effects on SctO2 before and after BCP and on SjvO2 before BCP.
- Subjects :
- Vasopressin
Beach chair position
Clinical Research Article
Shoulder surgery
Arginine
business.industry
medicine.medical_treatment
Dose dependence
Ischemia
Jugular venous oxygen saturation
medicine.disease
lcsh:RD78.3-87.3
Anesthesiology and Pain Medicine
Systemic hemodynamics
lcsh:Anesthesiology
Anesthesia
Regional cerebral oxygen saturation
medicine
In patient
Arginine vasopressin
business
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- Language :
- English
- ISSN :
- 20057563 and 20056419
- Volume :
- 68
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Korean Journal of Anesthesiology
- Accession number :
- edsair.doi.dedup.....a10af81a311396b0f7377d793c2a0d1b