The Correlation Of Blood Pressure And Cerebral Regional Oxygen Saturation During Carotid Endarterectomy

Objective:To evaluate the correlation between blood pressure?BP?and cerebral regional oxygen saturation?rSO₂?during carotid endarterectomy?CEA?.Methods:Thirty patients?age 50⁷5?scheduled for CEA were enrolled in the near-infrared spectroscopy?NIRS?study.The bilateral middle cerebral regional oxygen saturation and blood pressure were measured via NIRS at the following time points:Before anesthesia in the operation room?T0?,post anaesthesia?T1?,occlusion of the carotid artery?T2?,occlusion of the carotid artery for 5 mins?T3?,5 minutes before the opening of the carotid artery?T4?,opening carotid artery?T5?,opening carotid artery for 5mins?T6?and opening carotid artery for 20mins?T7?respectively.Analysis of the correlation of data.The head CT and neck CTA or DSA were reviewed after operation.Observation of the incidence of postoperative complications.The patients were followed up for 3 days.Results:All the 30 patients were recorded MAP and bilateral rSO₂.The difference between MAP and T0 at T2^T7 time points was Statistically significant?P<0.05?.The difference between rSO₂ on the side of operation and T0 at T2^T4 time points was Statistically significant?P<0.05?.Compared with non operative rSO₂,the rSO₂ on the side of the operation was significantly reduced in T2^T4?P<0.05?.The correlation between MAP and rSO₂ on the side of operation was significantly positive at T2-T5.T2?r=0.587,P<0.01??T3?r=0.840,P<0.01??T4?r=0.627,P<0.01??T5?r=0.520,P<0.01?.The changes of MAP are the same at side of the operation.but the opposite in the early periodofcarotidarteryocclusionandEarlyperiodcarotidartery opening?r=-0.539,P<0.05;r=-0.574,P<0.01?.After operation,there were no severe complications such as limb paralysis and impaired consciousness.Computed tomography angiography and digital subtraction angiography showed patency of the carotid artery.Conclusion:1.Statistical analysis data,the changes of BP are the same at CEA side cerebral regional oxygen saturation.Changes in cerebral oxygen saturation can also be used as a reference for intraoperative blood pressure regulation.Compared with empirical regulation of blood pressure has obvious advantages.2.Combined monitoring of blood pressure and cerebral oxygen saturation.It is great significance to improve the safety of CEA operation.