Near-infrared spectroscopy for assessing microcirculation during laparoscopic gynaecological surgery under combined spin
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ORIGINAL RESEARCH
Near‑infrared spectroscopy for assessing microcirculation during laparoscopic gynaecological surgery under combined spinal‑general anaesthesia or general anaesthesia alone: a randomised controlled trial Marko Zdravkovic1,2 · Matej Podbregar3 · Mirt Kamenik1,2 Received: 6 September 2019 / Accepted: 19 October 2019 © Springer Nature B.V. 2019
Abstract While pneumoperitoneum causes negative macrohaemodynamic effects, much less is known about microcirculatory effects of different anaesthetic techniques and laparoscopy. Therefore, we aimed to explore microcirculatory effects of combined spinal–general anaesthesia and laparoscopy, as measured by near-infrared spectroscopy over forearm and calf muscles utilising a 3-min ischemic challenge. Patients (n = 102) undergoing elective laparoscopic gynaecological surgery were randomised to receive general anaesthesia alone or in combination with high-dose or low-dose spinal analgesia (levobupivacaine 7.5 mg or 3.75 mg, respectively, plus sufentanil 2.5 μg). Primary outcomes were near-infrared spectroscopy derived parameters before general anaesthesia induction, 5 min after tracheal intubation, and 15 min after pneumoperitoneum commencement. General anaesthesia resulted in impaired post-ischaemic recovery rate in the forearm (p 35 kg m−2 or
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