The Relationship between Cerebral Desaturation and Postoperative Cognitive Dysfunction in Carotid Endarterectomy Surgery: A Prospective Observational Study

Makaleler > Tam Makale · 2026

Yazarlar: Aslan Zafer Atilgan, Esin Ozturk, Cengiz ŞAHUTOĞLU, Seden Kocabas, Fatma Zekiye Askar

AIN SHAMS JOURNAL OF ANESTHESIOLOGY, ESCI İndekslerine Giren Dergi, Uluslararası, Wos, 2026, cilt 18, ss 1-7

DOI: 10.21608/ASJA.2024.256095.1042

Özet

<p>Background:&nbsp;Carotid&nbsp;endarterectomy&nbsp;(CEA)&nbsp;is&nbsp;an&nbsp;established&nbsp;surgical&nbsp;procedure&nbsp;for&nbsp;patients&nbsp;with&nbsp;high-grade&nbsp;carotid&nbsp;artery&nbsp;stenosis.&nbsp;Cerebral&nbsp;hypoperfusion&nbsp;after&nbsp;clamping&nbsp;the&nbsp;carotid&nbsp;artery&nbsp;can&nbsp;lead&nbsp;to&nbsp;the&nbsp;development&nbsp;of&nbsp;new&nbsp;strokes&nbsp;or&nbsp;worsen&nbsp;existing&nbsp;damage.&nbsp;Near-infrared&nbsp;spectroscopy&nbsp;(NIRS)&nbsp;provides&nbsp;continuous&nbsp;and&nbsp;non-invasive&nbsp;monitoring&nbsp;of&nbsp;cerebral&nbsp;oxygenation,&nbsp;allowing&nbsp;for&nbsp;early&nbsp;detection&nbsp;of&nbsp;cerebral&nbsp;ischemia&nbsp;due&nbsp;to&nbsp;hypoperfusion&nbsp;in&nbsp;critical&nbsp;patients&nbsp;and&nbsp;a&nbsp;reduction&nbsp;in&nbsp;early&nbsp;complications.&nbsp;Postoperative&nbsp;cognitive&nbsp;dysfunction&nbsp;(POCD)&nbsp;refers&nbsp;to&nbsp;changes&nbsp;in&nbsp;cognitive&nbsp;function&nbsp;following&nbsp;surgery&nbsp;and&nbsp;anesthesia.&nbsp;Methods:&nbsp;In&nbsp;this&nbsp;prospective&nbsp;and&nbsp;observational&nbsp;study,&nbsp;our&nbsp;aim&nbsp;is&nbsp;to&nbsp;evaluate&nbsp;whether&nbsp;cerebral&nbsp;desaturation,&nbsp;as&nbsp;assessed&nbsp;by&nbsp;NIRS,&nbsp;contributes&nbsp;to&nbsp;the&nbsp;occurrence&nbsp;of&nbsp;POCD.&nbsp;Hemodynamic&nbsp;and&nbsp;NIRS&nbsp;assessments&nbsp;were&nbsp;recorded&nbsp;at&nbsp;various&nbsp;time&nbsp;points:&nbsp;baseline,&nbsp;post-intubation,&nbsp;pre-clamping,&nbsp;5th&nbsp;and&nbsp;10th&nbsp;minutes&nbsp;after&nbsp;carotid&nbsp;clamping,&nbsp;5th&nbsp;minutes&nbsp;after&nbsp;unclamping,&nbsp;pre-extubation,&nbsp;and&nbsp;the&nbsp;end&nbsp;of&nbsp;the&nbsp;operation.&nbsp;The&nbsp;Mini-Mental&nbsp;Status&nbsp;Examination&nbsp;was&nbsp;administered&nbsp;to&nbsp;patients&nbsp;on&nbsp;the&nbsp;day&nbsp;before&nbsp;surgery&nbsp;and&nbsp;the&nbsp;second&nbsp;day&nbsp;after&nbsp;surgery.&nbsp;Results:&nbsp;Cerebral&nbsp;desaturation&nbsp;was&nbsp;observed&nbsp;in&nbsp;33%&nbsp;of&nbsp;patients.&nbsp;Regional&nbsp;cerebral&nbsp;oxygen&nbsp;saturation&nbsp;(rSO2)&nbsp;showed&nbsp;a&nbsp;slight&nbsp;decrease&nbsp;in&nbsp;the&nbsp;early&nbsp;stages&nbsp;after&nbsp;clamping&nbsp;the&nbsp;carotid&nbsp;artery.&nbsp;During&nbsp;the&nbsp;clamping&nbsp;period,&nbsp;rSO2&nbsp;values&nbsp;increased,&nbsp;and&nbsp;by&nbsp;the&nbsp;end&nbsp;of&nbsp;the&nbsp;operation,&nbsp;they&nbsp;had&nbsp;returned&nbsp;to&nbsp;baseline&nbsp;or&nbsp;even&nbsp;exceeded&nbsp;baseline&nbsp;levels.&nbsp;We&nbsp;did&nbsp;not&nbsp;identify&nbsp;any&nbsp;cases&nbsp;of&nbsp;POCD&nbsp;during&nbsp;the&nbsp;early&nbsp;postoperative&nbsp;periods.&nbsp;Conclusions:&nbsp;NIRS&nbsp;is&nbsp;a&nbsp;practical&nbsp;and&nbsp;effective&nbsp;method&nbsp;for&nbsp;detecting&nbsp;cerebral&nbsp;hypoperfusion.&nbsp;However,&nbsp;based&nbsp;on&nbsp;our&nbsp;study,&nbsp;we&nbsp;were&nbsp;unable&nbsp;to&nbsp;establish&nbsp;a&nbsp;correlation&nbsp;between&nbsp;NIRS&nbsp;values&nbsp;and&nbsp;the&nbsp;occurrence&nbsp;of&nbsp;POCD.</p>

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