Research Article
BibTex RIS Cite

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

Year 2022, Volume: 6 Issue: 2, 143 - 149, 30.08.2022

Gonca Kaya Mert Onur Avcı Oğuz Gündoğdu Cemil İsbir İclal Özdemir Kol Sinan Gürsoy Kenan Kaygusuz

https://doi.org/10.46332/aemj.1017231

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

Thanks

We thank all the members of the anesthesiology departments.

References

  • 1. Roger VL, Go AS, Lyoyd-Jones DM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011;123(4):18-209.
  • 2. Silver FL, Mackey A, Clark WM, et al. Safety of stenting and endarterectomy by symptomatic status in the carotid revascularization endarterectomy versus stenting trial. Stroke. 2011;42(3):675-680.
  • 3. Barnett HJM, Taylor DW, Haynes RB. Beneficial effect of carotid endarterectomy in symptomatic patients with highgrade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1991;325(7):445-453.
  • 4. Farrell B, Fraser A, Sandercock P, et al. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351(9113):1379-1387.
  • 5. Vaniyapong T , Chongruksut W , Rerkasem K . Local versus general anaesthesia for carotid endarterectomy Cochrane Database Syst Rev. 2013;(12): CD000126.
  • 6. Meershoek AJA, Waard DD, Trappenburg J, et al. Clinical Response to Procedural Stroke Following Carotid Endarterectomy: A Delphi Consensus Study. Eur J Vasc Endovasc Surg. 2021;62(3):350-357.
  • 7. Rémy P, Benjamin P, Yann LT, et al. Predictive Factors of Silent Brain Infarcts after Asymptomatic Carotid Endarterectomy. Ann. Vasc. Surg. 2018;51:225-233.
  • 8. Estruch-Pérez MJ, Barberá-Alacreu M, Ausina-Aguilar A, Soliveres-Ripoll J, Solaz-Roldán C, Morales-SuárezVarela MM. Bispectral index variations in patients with neurological deficits during awake carotid endarterectomy. Eur. J. Anaesthesiol. 2010;27(4):359-363.
  • 9. Fu H, Fan L, Wang T. Perioperative neurocognition in elderly patients. Curr Opin Anaesthesiol. 2018;31(1):24-29.
  • 10. Wu L, Zhao H, Weng H, Ma D. Lasting effects of general anesthetics on the brain in the young and elderly: “mixed picture” of neurotoxicity, neuroprotection and cognitive impairment. J. Anesth. 2019;33(2):321–335.
  • 11. Kim W, Taw B, Yokosako S, et al. The future of non-invasive cerebral oximetry in neurosurgical procedures: A systematic review. MNI Open Research. 2018;2(3):3.
  • 12. Redford D, Paidy S, Kashif F. Absolute and trend accuracy of a new regional oximeter in healthy volunteers during controlled hypoxia. Anesth. Analg. 2014;119(6):1315-1319.
  • 13. Carlin RE, McGraw DJ, Calimlim JR, Mascia MF. The use of near-infrared cerebral oximetry in awake carotid endarterectomy. J. Clin. Anesth. 1998;10(2):109-113.
  • 14. Pedrini L, Magnoni F, Sensi L, et al. Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery? Stroke Res Treat. 2012;2012:156975.
  • 15. Radak D, Sotirovic V, Obradovic M, Isenovic ER. Practical use of near-infrared spectroscopy in carotid surgery. Angiology. 2014;65(9):769-772.
  • 16. Mille T, Tachimiri ME, Klersy C, et al. Near-infrared spectroscopy monitoring during carotid endarterectomy: which threshold value is critical? Eur. J. Vasc. Endovasc. Surg. 2004;27(6):646-650.
  • 17. Ritter JC, Green D, Slim H, Tiwari A, Brown J, Rashid H. The role of cerebral oximetry in combination with awake testing in patients undergoing carotid endarterectomy under local anaesthesia. Eur. J. Vasc. Endovasc. Surg. 2011;41(5):599-605.

Karotis Endarterektomi Cerrahisinin Serebral Oksijenizasyon Üzerine Etkileri, Randomize Klinik Çalışma

Year 2022, Volume: 6 Issue: 2, 143 - 149, 30.08.2022

Gonca Kaya Mert Onur Avcı Oğuz Gündoğdu Cemil İsbir İclal Özdemir Kol Sinan Gürsoy Kenan Kaygusuz

https://doi.org/10.46332/aemj.1017231

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

References

  • 1. Roger VL, Go AS, Lyoyd-Jones DM, et al. Heart disease and stroke statistics--2011 update: a report from the American Heart Association. Circulation. 2011;123(4):18-209.
  • 2. Silver FL, Mackey A, Clark WM, et al. Safety of stenting and endarterectomy by symptomatic status in the carotid revascularization endarterectomy versus stenting trial. Stroke. 2011;42(3):675-680.
  • 3. Barnett HJM, Taylor DW, Haynes RB. Beneficial effect of carotid endarterectomy in symptomatic patients with highgrade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1991;325(7):445-453.
  • 4. Farrell B, Fraser A, Sandercock P, et al. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351(9113):1379-1387.
  • 5. Vaniyapong T , Chongruksut W , Rerkasem K . Local versus general anaesthesia for carotid endarterectomy Cochrane Database Syst Rev. 2013;(12): CD000126.
  • 6. Meershoek AJA, Waard DD, Trappenburg J, et al. Clinical Response to Procedural Stroke Following Carotid Endarterectomy: A Delphi Consensus Study. Eur J Vasc Endovasc Surg. 2021;62(3):350-357.
  • 7. Rémy P, Benjamin P, Yann LT, et al. Predictive Factors of Silent Brain Infarcts after Asymptomatic Carotid Endarterectomy. Ann. Vasc. Surg. 2018;51:225-233.
  • 8. Estruch-Pérez MJ, Barberá-Alacreu M, Ausina-Aguilar A, Soliveres-Ripoll J, Solaz-Roldán C, Morales-SuárezVarela MM. Bispectral index variations in patients with neurological deficits during awake carotid endarterectomy. Eur. J. Anaesthesiol. 2010;27(4):359-363.
  • 9. Fu H, Fan L, Wang T. Perioperative neurocognition in elderly patients. Curr Opin Anaesthesiol. 2018;31(1):24-29.
  • 10. Wu L, Zhao H, Weng H, Ma D. Lasting effects of general anesthetics on the brain in the young and elderly: “mixed picture” of neurotoxicity, neuroprotection and cognitive impairment. J. Anesth. 2019;33(2):321–335.
  • 11. Kim W, Taw B, Yokosako S, et al. The future of non-invasive cerebral oximetry in neurosurgical procedures: A systematic review. MNI Open Research. 2018;2(3):3.
  • 12. Redford D, Paidy S, Kashif F. Absolute and trend accuracy of a new regional oximeter in healthy volunteers during controlled hypoxia. Anesth. Analg. 2014;119(6):1315-1319.
  • 13. Carlin RE, McGraw DJ, Calimlim JR, Mascia MF. The use of near-infrared cerebral oximetry in awake carotid endarterectomy. J. Clin. Anesth. 1998;10(2):109-113.
  • 14. Pedrini L, Magnoni F, Sensi L, et al. Is Near-Infrared Spectroscopy a Reliable Method to Evaluate Clamping Ischemia during Carotid Surgery? Stroke Res Treat. 2012;2012:156975.
  • 15. Radak D, Sotirovic V, Obradovic M, Isenovic ER. Practical use of near-infrared spectroscopy in carotid surgery. Angiology. 2014;65(9):769-772.
  • 16. Mille T, Tachimiri ME, Klersy C, et al. Near-infrared spectroscopy monitoring during carotid endarterectomy: which threshold value is critical? Eur. J. Vasc. Endovasc. Surg. 2004;27(6):646-650.
  • 17. Ritter JC, Green D, Slim H, Tiwari A, Brown J, Rashid H. The role of cerebral oximetry in combination with awake testing in patients undergoing carotid endarterectomy under local anaesthesia. Eur. J. Vasc. Endovasc. Surg. 2011;41(5):599-605.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Gonca Kaya Mert This is me 0000-0002-6991-8261

Onur Avcı 0000-0003-0743-754X

Oğuz Gündoğdu 0000-0002-8864-0015

Cemil İsbir 0000-0003-4094-7584

İclal Özdemir Kol 0000-0001-8247-440X

Sinan Gürsoy 0000-0003-0259-9750

Kenan Kaygusuz 0000-0002-0745-4633

Early Pub Date August 16, 2022
Publication Date August 30, 2022
Published in Issue Year 2022 Volume: 6 Issue: 2

Cite

APA Kaya Mert, G., Avcı, O., Gündoğdu, O., İsbir, C., et al. (2022). The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial. Ahi Evran Medical Journal, 6(2), 143-149. https://doi.org/10.46332/aemj.1017231
AMA Kaya Mert G, Avcı O, Gündoğdu O, İsbir C, Özdemir Kol İ, Gürsoy S, Kaygusuz K. The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial. Ahi Evran Med J. August 2022;6(2):143-149. doi:10.46332/aemj.1017231
Chicago Kaya Mert, Gonca, Onur Avcı, Oğuz Gündoğdu, Cemil İsbir, İclal Özdemir Kol, Sinan Gürsoy, and Kenan Kaygusuz. “The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial”. Ahi Evran Medical Journal 6, no. 2 (August 2022): 143-49. https://doi.org/10.46332/aemj.1017231.
EndNote Kaya Mert G, Avcı O, Gündoğdu O, İsbir C, Özdemir Kol İ, Gürsoy S, Kaygusuz K (August 1, 2022) The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial. Ahi Evran Medical Journal 6 2 143–149.
IEEE G. Kaya Mert, “The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial”, Ahi Evran Med J, vol. 6, no. 2, pp. 143–149, 2022, doi: 10.46332/aemj.1017231.
ISNAD Kaya Mert, Gonca et al. “The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial”. Ahi Evran Medical Journal 6/2 (August 2022), 143-149. https://doi.org/10.46332/aemj.1017231.
JAMA Kaya Mert G, Avcı O, Gündoğdu O, İsbir C, Özdemir Kol İ, Gürsoy S, Kaygusuz K. The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial. Ahi Evran Med J. 2022;6:143–149.
MLA Kaya Mert, Gonca et al. “The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial”. Ahi Evran Medical Journal, vol. 6, no. 2, 2022, pp. 143-9, doi:10.46332/aemj.1017231.
Vancouver Kaya Mert G, Avcı O, Gündoğdu O, İsbir C, Özdemir Kol İ, Gürsoy S, Kaygusuz K. The Effects of Carotid Endarterectomy Surgery on Cerebral Oxygenation, Randomized Clinical Trial. Ahi Evran Med J. 2022;6(2):143-9.
 Download Cover Image

Ahi Evran Medical Journal  is indexed in ULAKBIM TR Index, Turkish Medline, DOAJ, Index Copernicus, EBSCO and Turkey Citation Index. Ahi Evran Medical Journal is periodical scientific publication. Can not be cited without reference. Responsibility of the articles belong to the authors.

    Creative Commons Lisansı

This journal is licensed under the Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı.