Ephedrine and phenylephrine induce opposite changes in cerebral and paraspinal tissue oxygen saturation, measured with near-infrared spectroscopy: a randomized controlled trial

While the effects of phenylephrine (PE) and ephedrine (E) on cerebral oxygen saturation (rS c O 2 ) already has been studied, the effect on paraspinal oxygen saturation (rS ps O 2 ) is still unexplored. This study aims to assess the effect of PE and E on rS c O 2 and rS ps O 2 , measured with near-i...

Full description

Saved in:
Bibliographic Details
Published inJournal of clinical monitoring and computing Vol. 34; no. 2; pp. 253 - 259
Main Authors Vanpeteghem, Caroline M., Bruneel, Bas Y., Lecoutere, Isabeau M., De Hert, Stefan G., Moerman, Anneliese T.
Format Journal Article
LanguageEnglish
Published Dordrecht Springer Netherlands 01.04.2020
Springer Nature B.V
Subjects
Online AccessGet full text

Cover

Loading…
More Information
Summary:While the effects of phenylephrine (PE) and ephedrine (E) on cerebral oxygen saturation (rS c O 2 ) already has been studied, the effect on paraspinal oxygen saturation (rS ps O 2 ) is still unexplored. This study aims to assess the effect of PE and E on rS c O 2 and rS ps O 2 , measured with near-infrared spectroscopy. A randomized 4-treatment cross-over trial was designed in 28 patients under BIS-titrated anaesthesia with sevoflurane. If MAP decreased more than 20% from baseline, incremental doses of PE and/or E were given according to the randomization (group I: E–PE–E, group II: PE–E–PE, group III: E–E–E, group IV: PE–PE–PE). rS c O 2 and rS ps O 2 on T 3 –T 4 , T 9 –T 10 and L 1 –L 2 were recorded. Differences in rSO 2 (post-pretreatment) within each group were analyzed with paired Student’s t test. Differences in effects of PE and E on rS c O 2 and rS ps O 2 were analyzed with linear mixed-modelling. Following PE administration, rS c O 2 decreased significantly (– 2.7% ± 3.5), while it remained stable following E (– 0.6% ± 3.6). Contrastingly, rS ps O 2 at T 3 –T 4 , T 9 –T 10 and L 1 –L 2 slightly increased following PE (0.4% ± 2.5, 0.7% ± 2.0 and – 0.1% ± 1.4, respectively), while it decreased after E administration (– 1.3% ± 3.4%, – 0.7% ± 2.6% and – 1.3% ± 2.7%, respectively). Compared to E, PE administration was associated with a significant decrease in rS c O 2 (– 2.1%, 95% CI [– 3.1%, – 1.2%], p < 0.001). In contrast, compared to PE, E was associated with a significant decrease in rS ps O 2 at T 3 –T 4 , T 9 –T 10 and L 1 –L 2 (– 2.0%, 95% CI [– 2.8, – 1.1], p < 0.001; – 1.4%, 95% CI [– 2.4%, – 0.4%], p = 0.006; and – 1.5%, 95% CI [– 2.3%, – 0.8%], p < 0.001, respectively). An opposite effect on rS c O 2 and rS ps O 2 was observed after bolus administration of PE and E.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-019-00328-6