Karotis Endarterektomi Cerrahisinin Serebral Oksijenizasyon Üzerine Etkileri, Randomize Klinik Çalışma

Abstract

Amaç: Bu çalışmanın amacı kross-klemp süresi ile Near Infrared Spektroskopi (NIRS) değerlerinin nasıl değiştiğini gözlemlemektir.

Araçlar ve Yöntem: Çalışmaya 30 hasta dahil edildi. Genel anestezi indüksiyonu öncesi sistolik kan basıncı (SKB), diyastolik kan basıncı (DKB), ortalama arter basıncı (OAB), kalp atım hızı (KAH) ve periferik oksijen satürasyonu (SpO₂) ve bölgesel oksijen saturasyonu (rSO₂) değerleri sağ ve sol taraf olarak kaydedildi. Aynı parametreler karotis KK öncesi, karotis KK başlangıcının 3. dakika, 5. dakika, 10. dakikasında, kros klemp kalktıktan sonra 1. ve 5. dakikada ve postoperatif olarak kaydedildi. 

Bulgular: Çalışmaya alınan ve sağ taraftan cerrahi geçiren (n:11) hastaların sağ taraf ortalama rSO₂ değerleri arası farklılık anlamlı bulundu (p<0.05). Çalışmaya alınan ve sol taraftan cerrahi geçiren (n=19) hastaların sol taraf ortalama rSO₂ değerleri arası farklılık anlamlı bulundu (p<0.05). Çalışmaya alınan hastaların hiçbirinde postoperatif nörolojik komplikasyon izlenmemiştir.

Sonuç: Sonuç olarak genel anestezi altında KEA cerrahisi yapılan hastalarda KK sırasında serebral oksijen satürasyonunda belirgin bir düşüş olduğunu, KK açılmasının ardından serebral oksijen saturasyonun bazal değere tekrar ulaştığını veya bazal değerin de üzerine çıktığını gözlemledik.

Keywords

• carotis endarterectomi
• near-infrared spektroskopi
• serebral iskemi

The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial

Abstract

Purpose: The aim of this study is to assess how NIRS values changed with cross-clamp (CC) duration in carotis endarterectomy (CEA) surgeries.

Materials and Methods: The study included 30 patients. Before induction of general anesthesia, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO₂), and regional oxygen saturation(rSO₂) values were recorded as right and left sides. The same parameters were recorded before the carotid CC, at the 3rd, 5th, and 10th minutes of the carotid CC, and at the 1st and 5th minutes after the cross-clamp removal postoperatively.

Results: When the rSO₂ values of the study participants were measured at different times, there was a significant difference (p<0.05) between the right-sided mean rSO₂ values of the patients who underwent right-sided surgery (n=11). There was also a significant difference (p<0.05) between the left-sided mean rSO₂ values of the patients who underwent left-sided surgery (n=19).

Conclusion: We discovered that there was a significant decrease in cerebral oxygen saturation during CC in patients who had CEA surgery under general anesthesia and that cerebral oxygen saturation reached or exceeded the basal value after the CC was opened. 

Keywords

• carotid endarterectomy
• cerebral ischemia
• near-infrared spectroscopy

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