Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial.

Study Objective: To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo ₂ ) during laparoscopic cholecystectomy.
Design: Randomized, prospective and single-blinded study.
Setting: Academic hospital.
Patients: ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014.
Measurements: Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo ₂ ), 10 minutes after positioning the patient into reverse Trendelenburg's position (TrtCo ₂ ), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia.
Main Results: Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo ₂ values. Statistically higher rSco ₂ values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo ₂ , TrtCo ₂ , Tpost, Trec30 and Trec60 and incidence of critical rcSo ₂ decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications.
Conclusions: VIMA technique provides significantly (4%-11%) higher rcSO ₂ values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO ₂ decreases.
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