title: Monitoring brain oxygen saturation during awake off-pump coronary artery bypass.
abstract: OBJECTIVE
  To evaluate the changes in cerebral blood flow during awake off-pump coronary artery bypass grafting and compare with the changes during off-pump coronary artery bypass grafting under general anesthesia, using continuous monitoring of regional cerebral oxygen saturation.
  
  
  METHODS
  The study population comprised 3 groups of patients who had undergone off-pump coronary artery bypass grafting with thoracic epidural anesthesia, general anesthesia, or a combination of the two. Regional brain oxygen saturation, determined with a near-infrared oxygen monitor, and mean arterial pressure during surgery were calculated and compared among the 3 groups.
  
  
  RESULTS
  Patients who had undergone awake off-pump coronary artery bypass grafting with thoracic epidural anesthesia had a significantly higher cerebrovascular impairment ratio, and the EuroSCORE was high. No significant differences were observed among the 3 groups in terms of the relationship between mean arterial pressure during surgery and regional brain oxygen saturation. It is suggested that there were no differences in cerebral blood flow and mean arterial pressure changes among the 3 groups.
  
  
  CONCLUSIONS
  Awake off-pump coronary artery bypass grafting is a safe surgical technique for patients with history of cerebral infarction or impaired cerebral blood flow. Awake off-pump coronary artery bypass grafting is a less invasive procedure that allows efficient management of intraoperative cerebral blood flow, and can be equally effective as a percutaneous coronary intervention.
authors: Department of General and Cardiothoracic Surgery, KanazawaUniversity, Kanazawa, Japan. atoridanobu@yahoo.co.jp
authors: Arinobu
authors: A
authors: Toda
authors: Go
authors: G
authors: Watanabe
authors: Isao
authors: I
authors: Matsumoto
authors: Shigeyuki
authors: S
authors: Tomita
authors: Shojiro
authors: S
authors: Yamaguchi
authors: Hiroshi
authors: H
authors: Ohtake
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019265:Spectroscopy, Near-Infrared; D014851:Wakefulness
chemical_list: D015415:Biomarkers; D010100:Oxygen