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Journals / Cukurova Medical Journal / 2021 / Cilt: 46 - Sayı: 4

Changes in cerebral oxygenation and cognitive functions during controlled hypotension

Kontrollü hipotansiyon sırasında serebral oksijenasyon ve kognitif fonksiyonlarda meydana gelen değişiklikler

Bengü Gülhan AYDIN
Gamze KÜÇÜKOSMAN
Özcan PİŞKİN
Necla GÜLÇEK
Rahşan Dilek OKYAY
Hilal AYOĞLU
Pages
1614–1623
Publication Date
2021-12-30
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Cerebral desaturation seen during hypotensive anesthesia may cause early POCD development, therefore we think that close cerebral and hemodynamic monitoring during hypotensive anesthesia may preserve cognitive functions.

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: This study aimed to evaluate the effect of controlled hypotension on cerebral oxygen saturation and postoperative cognitive dysfunction (POCD) in patients undergoing nasal surgery.
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Key Findings & Data:Materials and Methods: Forty patients were randomized by a sealed envelope method into two drug groups: esmolol (Group E, n=20) or nitroglycerin (Group N, n=20) administration prior to surgical incision.
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Conclusion & Impact:Conclusion: Cerebral desaturation seen during hypotensive anesthesia may cause early POCD development, therefore we think that close cerebral and hemodynamic monitoring during hypotensive anesthesia may preserve cognitive functions.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Hipotansif anestezi · serebral oksijenasyon · kognitif fonksiyon

Abstract

Purpose: This study aimed to evaluate the effect of controlled hypotension on cerebral oxygen saturation and postoperative cognitive dysfunction (POCD) in patients undergoing nasal surgery. Materials and Methods: Forty patients were randomized by a sealed envelope method into two drug groups: esmolol (Group E, n=20) or nitroglycerin (Group N, n=20) administration prior to surgical incision. The cognitive functions of the patients were evaluated by the Mini-Mental State Examination Test 1 day before and 1 day after the operation. Regional oxygen saturation was monitored with near-infrared spectroscopy to detect cerebral desaturation. Results: The desired mean arterial blood pressure (50-65 mmHg) could be achieved in all groups. A decline in cognitive function occured in 16 patients (40%) at the 24th postoperative hour. There was no statistically significant difference between the groups in terms of POCD. There was a significant relationship between POCD and cerebral desaturation status. Conclusion: Cerebral desaturation seen during hypotensive anesthesia may cause early POCD development, therefore we think that close cerebral and hemodynamic monitoring during hypotensive anesthesia may preserve cognitive functions.

Özet

Amaç: Bu çalışmada, nazal cerrahi geçiren hastalarda uygulanan kontrollü hipotansiyonun serebral oksijen satürasyonu ve postoperatif kognitif disfonksiyon (POKD) üzerindeki etkisinin değerlendirmesi amaçlandı. Gereç ve Yöntem: Kırk hasta kapalı zarf yöntemi ile esmolol (Grup E, n=20) ve nitrogliserin (Grup N, n=20) olmak üzere iki gruba ayrıldı. Hastaların kognitif fonksiyonları operasyondan 1 gün önce ve 1 gün sonra Mini Mental Durum Testi ile değerlendirildi. Serebral desatürasyonu saptamak için rejyonel serebral oksijen satürasyonu yakın kızılötesi spektroskopi ile izlendi. Bulgular: Tüm gruplarda istenilen ortalama arteriyel kan basıncına (50-65 mmHg) ulaşıldı. Postoperatif 24. saatte 16 hastada (%40) kognitif fonksiyonlarda azalma meydana geldi. Postoperatif kognitif disfonksiyon açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu. Postoperatif kognitif disfonksiyon ile serebral desatürasyon arasında anlamlı bir ilişki olduğu görüldü. Sonuç: Hipotansif anestezi sırasında görülen serebral desatürasyon erken POKD gelişimine neden olabilmektedir, bu nedenle hipotansif anestezi sırasında yakın serebral ve hemodinamik monitorizasyon ile kognitif fonksiyonların korunabileceğini düşünmekteyiz.

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Cite This Article

AYDIN, B. G., KÜÇÜKOSMAN, G., PİŞKİN, Ö., GÜLÇEK, N., OKYAY, R. D., AYOĞLU, H. (2021). Changes in cerebral oxygenation and cognitive functions during controlled hypotension. Cukurova Medical Journal, Cilt: 46 - Sayı: 4, 1614–1623. https://ajindex.com/articles/420752

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