The aim of the present study is to evaluate the effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome following revascularization surgery in moyamoya patients.
Postoperative hyperperfusion syndrome is a common complication in moyamoya disease patients receiving revascularization surgery. Previously its incidence has been reported to be 17\~50%, but little remains regarding frequency of reperfusion injury after revascularization surgery in patients with moyamoya disease. Volatile anesthetics such as sevoflurane has been introduced clinically to reduce reperfusion injury and preconditioning with sevoflurane induced ischemic tolerance like as ischemic preconditioning. However, there was no report on the neuroprotective effect of sevoflurane postconditioning on ischemic/reperfusion injury in human brain. Therefore, We evaluated the neuroprotective effect of sevoflurane postconditioning on the incidence of postoperative hyperperfusion syndrome after revascularization surgery in moyamoya disease patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Masking
DOUBLE
Enrollment
152
administer 1.0 MAC (1.7\~2.0 vol%) of sevoflurane for 30 minutes after vascular anastomosis completed
The incidence of postoperative cerebral hyperperfusion syndrome
Cerebral hyperperfusion syndrome was defined if all the following four criteria were met: i) new development of postoperative focal neurological deficits, ii) a delayed neurological deficits which were not shown in the immediate postoperative period; iii) postoperative reversible neurological deficits which were completely resolved within 15 days after operation; iii) neither definite haematomas nor definite acute infarction on a brain CT scan, on diffusion magnetic resonance imaging, or both.
Time frame: postoperative day 15
The incidence of a new onset postoperative cerebral ischemia
cerebral ischemia is diagnosed by clinical symptoms and radiologic imaging (CT or MRI).
Time frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks.
The incidence of a new onset postoperative brain hematoma
postoperative brain hematoma is diagnosed by clinical symptoms and radiologic imaging (CT or MRI).
Time frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks.
The incidence of unrecovered neurological deficit
the incidence of postoperative neurological symptoms which persisted or not fully recovered until the patient's discharge.
Time frame: participants will be followed for the duration of hospital stay, an expected average of 3 weeks.
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