Impaired Capillary Recruitment Capacity in Obesity: A Subgroup Analysis of Prospective Observational Study on Anesthesia Effects

초록

Background: This subgroup analysis of prospective observational research, involving 71 participants, compared the effects of anesthesia on microvascular reactivity in obese vs lean individuals using near-infrared spectroscopy and vascular occlusion tests. The correlation between the body mass index (BMI) and microvascular reactivity under general anesthesia was also investigated. Material/Methods: This study enrolled adult patients classified as American Society of Anesthesiologists physical status I or II, undergoing elective surgery under general anesthesia. The microcirculatory variables measured before (Tpre) and 30 min following the induction of anesthesia (Tpost) were as follows: baseline tissue oxygen saturation (StO(2)), occlusion slope (del occl), and recovery slope (del recov). The patients were grouped according to their BMI (lean [BMI <25 kg/m(2)] vs obese [BMI >= 25 kg/m(2)]). Data are presented as medians and interquartile ranges. Results: There were 43 patients in the lean group and 28 in the obese group. At Tpre, baseline StO(2), del occl, and del recov were not different between the 2 groups (P=0.860, 0.659, and 0.518, respectively). At Tpost, the baseline StO(2) and del occl were not different between the 2 groups (P=0.343 and 0.791); however, the del recov was lower in the obese group than in the lean group (3.245 [2.737, 3.977] vs 4.131 [3.491, 4.843], P=0.003). At Tpost, BMI showed a moderate correlation with del recov (correlation coefficient: -0.319, P=0.007). Conclusions: In obese patients, capillary recruitment capacity during general anesthesia is compromised compared to lean patients.

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