Changes in cerebral oxygenation and cognitive functions during controlled hypotension

Changes in cerebral oxygenation and cognitive functions during controlled hypotension

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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) bushranger awning 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 kt196 torque converter 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.