The Changes of Tissue Oxygen Saturation Under Spinal Anesthesia

The Changes of Tissue Oxygen Saturation Under Spinal Anesthesia


Lead Sponsor: National Taiwan University Hospital

Source National Taiwan University Hospital
Brief Summary

Neuraxial anesthesia affords a less interventional way to desensitization of the lower body for surgical procedures. After introduction of neuraxial anesthesia, vasodilatation of body part below the anesthetic level is theoretically appeared as the sympathetic nerve efferent is blocked. The vasodilatation effect is related to hypotension, hypothermia, shivering and the response of volume redistribution. It is believed that vasodilatation leads to better regional tissue perfusion and better regional tissue oxygenation. Previous reports of laser doppler flowmetry and thermography showed their effectiveness on monitoring blocked level but they were not easily available in the operation room. Recently Near-infrared spectroscopy(NIRS) demonstrates real-time tissue oxygen saturation(rSO2) which is applied generally in non-invasive brain oximeter. We use NIRS in spinal anesthesia to monitor the tissue oxygenation change over the upper and lower limbs during the induction of neuraxial anesthesia.

Detailed Description

In patients who were planned to receive an operation with intrathecal anesthesia, NIRS (INVOS Cerebral Oximeter Model 5100B; Somanetics, Troy, MI, USA) with two adhesive patches was used to monitor rSO2. One patch was applied over the biceps brachii muscle,(the body part above the anaesthetic level), and the other patch was applied over the medial side of the gastrocnemius muscle of the non-surgical leg,(the body part below the anaesthetic level). In both extremities, rSO2 was monitored continuously and recorded every minute from before intrathecal bupivacaine injection until 15 min after injection. Isobaric bupivacaine 0.5% 10-15 mg was injected intrathecally and the level of anaesthesia was examined 10 min later by loss of cold sensation to alcohol swab by an anaesthetist not involved in the study. the changes of rSO2 of upper and lower extrimities were recorded and analysed.

Overall Status Unknown status
Start Date September 2008
Completion Date June 2011
Primary Completion Date December 2009
Study Type Observational
Enrollment 100

Intervention Type: Other

Intervention Name: tissue oxygen saturation, spinal anesthesia

Description: regional tissue oxygen saturation(rSO2)detected over upper and lower extremities before and after spinal anesthesia

Other Name: NIRS model - INVOS(Somanetics) 5100B Cerebral Oximetry


Sampling Method: Non-Probability Sample


Inclusion Criteria:

- patients who receive operations under spinal anesthesia

Exclusion Criteria:

- neurological, cardiovascular diseases

Gender: All

Minimum Age: 20 Years

Maximum Age: 80 Years

Healthy Volunteers: No

Overall Official
Last Name Role Affiliation
ya-jung cheng Principal Investigator department of anesthesiology, national taiwan university nospital
Overall Contact

Last Name: Ya-jung Cheng, MD.,PhD.

Phone: 886-2-23123456

Phone Ext.: 62158

Email: [email protected]

Facility: Status: Contact: National Taiwan University Hospital ya-jung cheng 886-2-23123456 62158 [email protected]
Location Countries


Verification Date

May 2011

Responsible Party

Name Title: Cheng ya-jung

Organization: Department of Anesthesiology, National Taiwan University Hospital

Has Expanded Access No
Arm Group

Label: 1Tissue oxygenation change

Description: Spinal anesthesia may result different changes of tissue oxygenation in blocked area ( upper extrimities ) and non-blocked area ( lower extrimities). The changes of tissue oxygenation saturation between upper and lower extremities in patients under spinal anesthesia for orthopedic surgery

Label: 2Tissue oxygenation change

Description: The changes of tissue oxygenation saturation between upper and lower extremities in patients under spinal anesthesia for cesarean section

Study Design Info

Observational Model: Case-Control

Time Perspective: Prospective