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...
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Published in | Journal of clinical monitoring and computing Vol. 34; no. 2; pp. 253 - 259 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Dordrecht
Springer Netherlands
01.04.2020
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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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. |
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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 |