Changes in cerebral oxygenation and cognitive functions during controlled hypotension

Bengü Gülhan Aydın; Gamze Küçükosman; Özcan Pişkin; Necla Gülçek; Rahşan Dilek Okyay; Hilal Ayoğlu

doi:10.17826/cumj.986099

EN TR

Changes in cerebral oxygenation and cognitive functions during controlled hypotension

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.

Keywords

Hypotensive anesthesia , cerebral oxygenation , cognitive function , esmolol , nitroglycerin

Kontrollü hipotansiyon sırasında serebral oksijenasyon ve kognitif fonksiyonlarda meydana gelen değişiklikler

Öz

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.

Anahtar Kelimeler

Hipotansif anestezi , serebral oksijenasyon , kognitif fonksiyon , esmolol , nitrogliserin

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Klinik Tıp Bilimleri

Bölüm

Araştırma Makalesi

Yazarlar

Bengü Gülhan Aydın ^*
0000-0002-1324-6144
Türkiye

Gamze Küçükosman
0000-0001-5224-0258
Türkiye

Özcan Pişkin
0000-0003-3538-0317
Türkiye

Necla Gülçek Bu kişi benim
0000-0003-1440-1705
Türkiye

Rahşan Dilek Okyay
0000-0002-0520-7532
Türkiye

Hilal Ayoğlu
0000-0002-6869-5932
Türkiye

Yayımlanma Tarihi

30 Aralık 2021

Gönderilme Tarihi

23 Ağustos 2021

Kabul Tarihi

12 Ekim 2021

Yayımlandığı Sayı

Yıl 2021 Cilt: 46 Sayı: 4

DOI

https://doi.org/10.17826/cumj.986099

IZ

https://izlik.org/JA75GT29BA

MLA

Aydın, Bengü Gülhan, vd. “Changes in cerebral oxygenation and cognitive functions during controlled hypotension”. Cukurova Medical Journal, c. 46, sy 4, Aralık 2021, ss. 1614-23, doi:10.17826/cumj.986099.

Bu eser Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.

Changes in cerebral oxygenation and cognitive functions during controlled hypotension

Abstract

Keywords

Kontrollü hipotansiyon sırasında serebral oksijenasyon ve kognitif fonksiyonlarda meydana gelen değişiklikler

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

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