Evidence map›Paper›PMID 34167290›Full record

SynthesisKorean journal of anesthesiology2021

Prophylactic measures to prevent cerebral oxygen desaturation events in elective beach-chair position shoulder surgeries: a systematic review and meta-analysis.

Thrivikrama Padur Tantry, Baikunje Golitadka Muralishankar, Harish Karanth, Pramal Karkala Shetty, Sunil Purushotham Shenoy, Dinesh Kadam, Gururaj Tanthry, Rithesh Shetty

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Korean journal of anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Thrivikrama Padur TantryDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Baikunje Golitadka MuralishankarDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Harish KaranthDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Pramal Karkala ShettyDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Sunil Purushotham ShenoyDepartment of Urology and Renal Transplant, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Dinesh KadamDepartment of Plastic and Reconstructive Surgery, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Gururaj TanthryDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Rithesh ShettyDepartment of Anesthesiology, A J Institute of Medical Sciences & Research Center, Kuntikana, Mangalore, India.
Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProphylaxis for cerebral desaturation events (CDEs) during anesthesia in the beach chair position (BCP) for shoulder surgeries has not been evaluated. We systematically analyzed the effectiveness of various prophylactic measures used in this clinical setting.

methodsWe performed a meta-analysis (PROSPERO; no. CRD42020167285) of trials reporting CDEs and regional cerebral oxygen saturation (rSO2) and jugular venous oxygen saturation (SjvO2) values in anesthetized patients undergoing shoulder surgery in BCP. Considering the type of prophylactic measures used (pharmacological or non-pharmacological), a subgroup analysis was planned. Outcomes included (1) rSO2 and SjvO2 data with and without prophylactic measures for CDEs, recorded for different time intervals, and (2) the number of patients experiencing CDEs and hypotension.

resultsTwelve studies (786 patients) were included in the analysis. We observed lower absolute rSO2 values for early and all-time periods for vasoactive agent prophylaxis. The lowest achieved rSO2 values were also lower for vasoactive agent prophylaxis. Risk of CDEs was higher with vasoactive agent prophylaxis. Subgroup analysis identified targeted mild hypercarbia as effective in preserving cerebral oxygenation. Similarly, targeted mild hypercarbia prevented the fall in rSO2 with position change. Meta-regressions revealed statistically significant highest estimates for vasoactive agent prophylaxis in contrast to targeted mild hypercarbia. Likelihood of not developing CDEs was higher for targeted mild hypercarbia. In contrast to rSO2, most prophylactic methods reduced hypotensive episodes.

conclusionsTargeted mild hypercarbia can reduce BCP-related CDEs. Evidence does not favor prophylactic use of vasoactive agents for the prevention of cerebral desaturations irrespective of whether their use interferes with cerebral oximetry readings.

Indexed as

Cerebrovascular CirculationShoulderArthroscopyHumansOximetryOxygenPatient PositioningOxygenArthroscopyOximetryProphylaxisRandomized Controlled TrialShoulderSitting positionStatistics

Identifiers

PMID34167290
PMCPMC8497913
OpenAlexW3176465366

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.