Discussion
bleeding, postoperative delirium, blood loss, cognitive dysfunction, hypotension
BLOOD LOSS, BLEEDING, INTRAOPERATIVE BLOOD LOSS, AIR EMBOLISM
In this prospective, single-center, single-blind, randomized controlled trial, we explored the effects of different PetCOTheoretically, elevated PaCODespite the use of a protocol designed to optimize MAP in the present study, hypotension was a frequent occurrence. In 84.7% of the patients (30 in the TN group and 31 in the TMH group), the MAP decreased by more than 20–30%, which required intervention. Intraoperative blood loss is challenging for hepatic surgeons due to the complicated anatomical structure and double blood supply system of the liver, and it is one of the major factors determining the success of laparoscopic surgery. Many reports have suggested an association between a CVP of < 5 mmHg and less blood loss or less transfusion during hepatectomy, so the LCVP technique is recommended in liver resection surgery to reduce bleeding [The present study showed that the TMH group had a stable rSOSeveral studies have shown that body position can influence rSOIn the present study, the incidence of postoperative delirium after surgery was similar between the two groups. We speculate that this may have occurred for the following reasons. First, we excluded patients aged > 70 years who are at a higher risk of cognitive dysfunction. Second, our study was performed at a setting with a well-implemented Enhanced Recovery After Surgery protocol, which may have accelerated patient recovery. Third, 10 mg dexamethasone was administered to every patient after the induction of general anesthesia at our center, which may have reduced the occurrence of postoperative delirium [Inconsistent with a previous study [The present study has several limitations that should be noted. First, the study was conducted at a single center and was a single-blinded study. However, the attending anesthesiologist was inevitably aware of the group allocation and the measured intraoperative variables. Second, the risk of air embolism may increase in patients undergoing laparoscopic hepatectomy under LCVP. PetCO