The Effect Of OLV On RSO₂ And SjvO₂ And Their Correlation

Objective: By observing the changes of jugular bulb venous oxygen saturation（SjvO₂）and regional cerebral oxygen saturation（rSO₂）in elder patients undergoing the thoracic surgery,the variations and correlation between SjvO₂ and rSO₂ during one-lung ventilation were discussed.Provide application basis of noninvasive cerebral oxygen saturation monitoring during clinical anesthesia.Methods:Twenty^two patients,aged ≥65 years old,ASA II or III,undergoing thoracic surgery and necessitating OLV were randomly selected.Left double^lumen endotracheal tube was used for OLV.The patients were treated with inhalation and intravenous anesthesia.In operating room,the patients’ vital signs were monitored such as noninvasive blood pressure（NIBP）,electrocardiogram（ECG）,heart rate（HR）,oxygen saturation（SpO₂）,nasopharyngeal temperature,the depth of anesthesia（BIS）and rSO₂.The anesthesia was induced with intravenous injection of atropine 0.5mg,midazolam 0.05⁰.1mg/kg,0.4 0.6μg/kg sufentanil,0.15⁰.2mg/kg cisatracurium,1¹.5mg/kg propofol.After the rapid sequence induction and the double^lumen tube well placed,intermittent positive pressure ventilation（IPPV）started.Tidal volume was set to 6⁸ml/kg,respiratory frequency was 12¹5times/min,inspiratory/expiratory ratio was 1:2.Patients were undegwent radial artery puncture of invasive arterial blood pressure monitoring and jugular vein retrograde catheter was placed under ultrasound monitoring.Inhaling pure oxygen 2 L/min,anesthesia was maintained with sevoflurane 2%,propofol 2 6mg/ kg /h,remaining BIS 40⁶0,remifentanil 0.1 0.3μg/ kg /min,intermittent additional CIS atracurium 0.05mg/kg.Stop the sevoflurane before the saturation while the propofol and remifentanil were induced until the end.The patient would be sent to the postanesthesia care unit after the surgery.The gender,age,weight,BMI of the patients were amounted.Six points in time were slected,which were T0（two-lung ventilation in supine position）,T1（two-lung ventilation in lateral decubitus）,T2（one-lung ventilation in lateral decubitus for 5 minutes）,T3（one-lung ventilation in lateral decubitus for 25 minutes）,T4（one-lung ventilation in lateral decubitus for 45 minutes）,T5（the end of one-lung ventilation）.And the stable rS02,SjvO₂,mean arterial pressure（MAP）,HR,SpO₂,nasopharyngeal temperature,BIS index,blood gas analysis were recorded in those times.Results: 1 At T1^T5,both of the SjvO₂ and rSO₂ were significantly decreased（P<0.05）;2 At T0,the SjvO₂ and rSO₂ was relative（P<0.05）.At T1^T5,there was no correlation between the SjvO₂ and rSO₂（P>0.05）,in other words,they couldn’t replace each other.Conclusions:During the elder men undergoing the one-lung ventilation in thoracic surgery,both of the SjvO₂ and rSO₂ were decreased.And there was no significantly association between them.