RESEARCH ARTICLE


Near Infrared Spectroscopy For Cerebral Hemodynamic Monitoring During Carotid Endarterectomy Under General Anesthesia



Letícia Cristina Dalledone Siqueira Rein1, *, Daniel Emílio Dalledone Siqueira2, Ana Terezinha Guillaumon2, Wagner Mauad Avelar3, Fernando Cendes3
1 Department of Surgery, School of Medical Sciences, Vascular Surgery, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP, Brazil
2 Department of Surgery, School of Medical Sciences, Vascular Surgery, UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP, Brazil
3 Department of Neurology, School of Medical Sciences, UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP, Brazil


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Creative Commons License
© 2022 Hassan et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Surgery, School of Medical Sciences, Vascular Surgery, Universidade Estadual de Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP, Brazil; Tel: +55-41-32333386; E-mail: leticiacdsiqueira@gmail.com


Abstract

Background:

Near infrared spectroscopy (NIRS) is a noninvasive method for continuous monitoring of cerebral oxygenation.

Objective:

To describe the intraoperative behavior of NIRS variables used to evaluate hemodynamic response in patients with atherosclerotic disease undergoing carotid endarterectomy under general anesthesia.

Methods:

Fifteen volunteers with atherosclerotic carotid disease with indications for endarterectomy were evaluated. After selection of patients, carotid stenosis was confirmed by appropriate diagnostic methods. NIRS was used for intraoperative monitoring. The variables total hemoglobin (Hb), oxygenated hemoglobin (O2Hb), deoxygenated hemoglobin (HHb), and regional oxygen saturation (rSO2) were evaluated at three intraoperative time points: before, during, and after carotid clamping.

Results and Discussion:

Measurements recorded by NIRS showed that, during the first 5 min of clamp time, patients experienced a decline in O2Hb levels, an increase in HHb levels, and a marked decrease in rSO2. Hb remained constant throughout the procedure. At the post-clamping time point, HHb, O2Hb, and rSO2 returned to patterns similar to those observed before clamping.

Conclusion:

NIRS was able to reliably and accurately identify the three stages of carotid endarterectomy and may predict the risk of cerebral hypoxia during carotid clamping under general anesthesia.

Keywords: Carotid endarterectomy, Carotid stenosis, Near-infrared spectroscopy , Atherosclerotic plaque, Carotid atherosclerotic disease, Carotid artery disease.