The Use of Near-Infrared Spectroscopy for the Measurement of Abdominal Wall Tissue Oxygenation During Pneumoperitoneum in Laparoscopic Cholecystectomy.

Abstract

Background: Near-infrared spectroscopy (NIRS) has been developed to monitor cerebral oxygenation. Various studies have investigated its utility in measuring somatic tissue oxygenation and in noncardiac surgeries. Aims: The aim of this study was to determine the effect of pneumoperitoneum on the abdominal wall. Study Design: A prospective, case-control study. Methods: This study included 70 patients who had elective laparoscopic cholecystectomy. A regional oximetry sensor was placed on the anterior abdominal wall in all patients. Primary outcome measures included preoperative regional tissue saturation (rSO₂) values. For secondary outcome measures, we recorded visual analogue scale (VAS) scores and tramadol usage at postoperative hours 2, 6, 12, and 24: intraoperative end-tidal CO₂ values; peripheral oxygen saturation (spo2); and abdominal subcutaneous fat tissue thickness. Results: The initial rSO₂ value (T1: 75.6 ± 6.64) was significantly higher than those measured at the predetermined time intervals during pneumoperitoneum (T4: 73.4 ± 6.3, T5: 68 ± 8.9, T6: 68 ± 8.9, T7: 66.6 ± 9.4, T8: 65.81 ± 10.2, T9: 65.6 ± 8.8) (P < .05). The mean change in rSO₂ between preoperative measurements (T1) and mid-pneumoperitoneum measurements (T8) was -12.9 ± 11%. This change was found to be negatively correlated with postoperative VAS scores and 24-hour tramadol consumption amounts. Conclusion: The results of the present study show that changes in abdominal wall tissue oxygenation during pneumoperitoneum can be measured with NIRS.