Korean J Anesthesiol.  2018 Apr;71(2):127-134. 10.4097/kjae.2018.71.2.127.

Compression stockings reduce the incidence of hypotension but not that of cerebral desaturation events in the beach-chair position: a randomized controlled trial

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea. ankyj@ewha.ac.kr
  • 2Department of Anesthesiology and Pain Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND
The beach-chair position (BCP) results in decreases in venous return, cardiac output, and cerebral perfusion pressure. In this randomized, prospective study, we investigated whether applying thigh-high compression stockings affected the maintenance of regional cerebral tissue oxygen saturation (rSO2) in the BCP.
METHODS
Patients undergoing orthopedic surgery in the BCP under general anesthesia were included and assigned randomly to the control or the compression stocking group. Appropriately sized thigh-high compression stockings were applied to the patients in the stockings group. All patients were tilted, up to 45°, throughout the operation. Non-invasive blood pressure, invasive arterial blood pressure zeroed at the external auditory meatus, and rSO2 were recorded.
RESULTS
Data were analyzed from 19 patients per group. In the BCP, the values of rSO2 and blood pressure decreased significantly compared with those at baseline, with no significant difference between the groups. The incidences of cerebral desaturation events (CDEs) were similar between the groups; however, that of hypotension was significantly lower in the compression stocking group. During 36 CDEs, the levels of rSO2 and blood pressure decreased significantly compared with those at baseline in both groups. No significant correlation was found between rSO2 and blood pressure.
CONCLUSIONS
Thigh-high compression stockings reduced the incidence of hypotension but not that of CDEs. Our results suggest that other factors, beyond hypotension itself, contribute to CDEs and in other words, efforts just to reduce the incidence of hypotension may not mainly contribute to a reduction of CDEs occurrence in the BCP under general anesthesia.

Keyword

Beach chair position; Cerebral perfusion pressure; Compression stockings; Hypotension; Near-infrared spectroscopy; Shoulder surgery

MeSH Terms

Anesthesia, General
Arterial Pressure
Blood Pressure
Cardiac Output
Cerebrovascular Circulation
Humans
Hypotension*
Incidence*
Orthopedics
Oxygen
Prospective Studies
Spectroscopy, Near-Infrared
Stockings, Compression*
Oxygen
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