[Relationship between postoperative neurological complications and regional cerebral oxygen saturation during retrograde cerebral perfusion].
BACKGROUND
Transient postoperative neurological disorders are common in patients undergoing aortic surgery with retrograde cerebral perfusion (RCP). We evaluated the relationship between transient postoperative neurological disorders and regional cerebral oxygen saturation (rSO2) during RCP.


METHODS
Thirty-seven patients with aortic aneurysm dissection were enrolled in the study. They underwent the ascending aorta or hemi-arch replacement. The postoperative neurological complications occurred in 17 patients, including 2 strokes, 1 hypoxic encephalopathy, 6 delay of awareness, and 8 disorientations. Strokes and a hypoxic encephalopathy were excluded because they could result from embolic episodes. Changes in rSO2 during RCP in 14 patients with transient neurological disorders were compared with changes in 20 patients without disorders.


RESULTS
The rSO2 values significantly decreased after the beginning of RCP in both groups. There was no difference in the lowest rSO2 value during RCP and in the rate of decrease from pre-RCP to the lowest rSO2 between two groups. However, the difference more than 10% between left and right was significantly associated with neurological disorders.


CONCLUSIONS
The rSO2 monitor could detect the decrease of cerebral perfusion during RCP. The wide asymmetry of rSO2 was associated with transient neurological disorders, although the lowest rSO2 value and the rate of decline did not relate.
Nishikawa
Haruko
H
Department of Anesthesiology, Yokohama City University Medical Center, Yokohama.
Oku
Rieko
R
Sato
Minako
M
Koide
Yasuhiro
Y
Okazaki
Kaoru
K
Sugawara
Kouji
K
D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001921:Brain / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D010101:Oxygen Consumption; D010477:Perfusion / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies