Controlled hypotension is currently used in spinal surgery to reduce bleeding at the surgical site, improve the surgeon's visibility, and decrease intraoperative blood loss. Although controlled hypotension is considered a beneficial method from a surgical perspective, it is important to be cautious about its side effects. One such side effect is cerebral perfusion insufficiency, which can be managed by monitoring cerebral circulation through regional cerebral oxygen saturation (rSO2). The aim of this study is to compare the effects of controlled hypotension at specific MAP ranges on cerebral oxygen saturation.
Controlled hypotension is currently used in spinal surgery to reduce bleeding at the surgical site, improve the surgeon's visibility, and decrease intraoperative blood loss. Although controlled hypotension is considered a beneficial method from a surgical perspective, it is important to be cautious about its side effects. One such side effect is cerebral perfusion insufficiency, which can be managed by monitoring cerebral circulation through regional cerebral oxygen saturation (rSO2). In the literature, various definitions of controlled hypotension exist. It is commonly defined as maintaining the Mean Arterial Pressure (MAP) between 50-65 mmHg, Systolic Arterial Pressure (SAP) between 80-90 mmHg, or reducing MAP by 30% compared to baseline values. In our study, we plan to maintain the MAP within the range of 55-75 mmHg and compare the effects of two different MAP levels on perioperative cerebral oxygen saturation, anesthetic and surgical parameters, and postoperative cognitive functions. The aim of this study is to compare the effects of controlled hypotension at specific MAP ranges on cerebral oxygen saturation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
60
MAP will be maintained between 55-65 mmHg during anesthesia.
MAP will be maintained between 66-75 mmHg during anesthesia.
Ankara Etlik City Hospital
Ankara, Varlık Mahallesi Yenimahalle, Turkey (Türkiye)
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: 5 minutes before induction of anesthesia
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: 5 minutes after intubation
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: 5 minutes after positioning prone
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: 1 minutes after first surgical incision is made
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: the time after one minutes target MAP value
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: the time after ten minutes target MAP value
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: the time after 20 minutes target MAP value
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: 5 minutes after extubation
Near infrared spectroscopy (NIRS)
cerebral oxygen saturation
Time frame: postextubation after 15 minutes
mini mental test
It is used to evaluate cognitive function.
Time frame: 15 minutes before induction of anesthesia
mini mental test
It is used to evaluate cognitive function.
Time frame: 30 minutes after extubation
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