Do we have changes in the cerebral regional oxygen saturation while undergoing carotid artery endarterectomy?

Abstract

Objectives (oral/poster only) Objectives: 1. To assess cerebral tissue oxygenation in neurosurgical patients having carotid endarterectomy using near-infrared spectroscopy (NIRS). 2. To assess the relationship between end-tidal carbon dioxide (EtCO2) and near-infrared spectroscopy (NIRS). 3. To analyze how frequently patients having carotid endarterectomy in the field of neurosurgery experience episodes of desaturation of the cerebral tissue, as well as any potential causes of this desaturation. Materials and methods (oral/poster only) The study was conducted at the Hospital of LUHS Kaunas Clinics Anesthesiology department. Twenty individuals who had carotid artery endarterectomy were included in the study. Measurements recorded after induction, before first surgical incision, after clamping of carotid artery of the operated side, (4) after restoration of carotid artery blood flow, before extubation or before transferring the not extubated patient to the intensive care unit. All patients were prepared for surgery according to a standard protocol, with additional NIRS sensors in the forehead area. MAP, SpO2, EtCO2, and rSO2 were monitored during the procedure. Results (oral/poster only) A marginal and statistically insignificant correlation between NIRS and MAP was discovered by the study. While there was no correlation between SpO2 and NIRS, there was a relatively high and statistically significant correlation when looking at the relationship with EtCO2. One-fifth (N = 4) of all patients experienced outbreaks of brain desaturation. The left carotid artery's functioning showed the most abnormalities (N = 3). Conclusions 1. After clamping the carotid artery of the operated side, patients' lowest NIRS readings (lowest regional oximetry values) were discovered. 2. There is a statistically significant and relatively strong connection between rSO2 and end-tidal exhaled carbon dioxide (EtCO2). Therefore, it may be claimed that as EtCO2 concentration rises, the body works to oxygenate the brain tissue better and guard against potential desaturation. 3. Throughout the entire carotid endarterectomy process, episodes of brain tissue desaturation are possible.