The Intermittent Sequential Compression Device on the Lower Extremities Attenuates the Decrease in Regional Cerebral Oxygen Saturation During Sitting Position Under Sevoflurane Anesthesia

Background: The sitting position has potential for serious complications such as cerebral ischemia and venous air embolism. This study investigated the effects of intermittent sequential compression device (SCD) on the changes in regional cerebral oxygen saturation (rSO(2)) during the sitting position. Methods: Sixty-six healthy patients undergoing shoulder arthroscopy in sitting position were randomly assigned to either control (N = 33) or SCD (N = 33) groups. Hemodynamic variables and the rSO(2) were measured 5 minutes after the induction of anesthesia (Tsupine, baseline values), and 1, 3, and 5 minutes after raising the patient to a 70-degree sitting position (T1, T3, and T5). The incidence of hypotension was recorded. Results: The incidence of hypotension was significantly higher in the control group (8/33) than that in the SCD group (1/33) (P = 0.027, odds ratio 0.170, 95% CI 0.042-0.684). The rSO(2) was significantly higher in the SCD group compared with those in the control group at T3 and T5. Within the group, rSO(2) decreased significantly only in the control group compared with baseline value at T1, T3, and T5. The % change in rSO(2) from T0 to T1, T3, and T5 were significantly lower in the SCD group compared to those in the control group. Conclusions: The application of SCD to the lower extremities during sitting position under sevoflurane anesthesia was a simple and effective method to attenuate the decrease in cerebral oxygen saturation.