Akademik Veri Yönetim Sistemi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.20, sa.2, ss.77-84, 2014 (Scopus)
Objective: In this study, effects of three different anesthetic agents on postoperative neurocognitive functions and changes on brain oxygen saturation monitored with near infrared spectroscopy with NIRS in heart surgery were presented. Material and Methods: Sixty two ASA II patients aged between 30-65 who were scheduled for coronary artery bypass surgery were included into the study. Two patients were excluded from the study because of initiation of inotropic support. All patients were evaluated preoperatively, ASEM and MMST was applied. Anesthesia induction was performed with 0.1 mg/kg midazolam, 10 μg/kg fentanyl, 0.3 mg/kg rocuronium. Patients were divided into three groups randomly. For anesthesia maintenance. Group I (Propofol Group, n: 20): 50-150 μg/kg/min propofol infusion during the operation. Group II (Sevoflurane Group, n: 20): sevoflurane about 1 MAC during the operation (also during cardiopulmonary bypass). Grup III (Midazolam Group, n: 20): 0.2-0.4 mg/kg/dk midazolam infusion during the operation. During 11 measurement time points named (baseline, after the entubation, before, and after the cannulation, at the start of bypass, at 34°C, 31°C (last temperature point), 32°C, 34°C, 36°C, after pump and skin closure) NIRS values, desaturations over 25%, and arterial blood gas values were recorded. Extubation time, ICU stay and hospitalization time were recorded for each intubated patient who had been sent to ICU unit postoperatively. ASEM ad MMST were applied to all cases 24 hour preoperatively, and at 1st, 2nd, 3rd, 4th, 5th day postoperatively. Results: There were no differences among three groups as for demographic values and, blood gases. MMST and ASEM evaluations showed no difference between groups at any measurement time point. MMST value decreased at 1st postoperative day significantly (p<0.01). There was no intragroup difference at any measurement period in ASEM test. SRO2-left, SRO2-right, rO 2-left, rO2-right values were not different from each other between groups at any measurement time point. These four parameters when compared in groups, there were decrease in measurements especially during cooling time but this decrease was not statistically significant between groups. There was not statistically significant difference between the group that has more than 25% decrease in right and left rO2 and the group that has no decrease in the way of post operative MMST and ASEM levels. Conclusion: In this study, we concluded that there was no difference between three different agents with respect to postoperative neurocognitive functions by means of follow up of the oxygen saturation in brain with NIRS during cardiopulmonary bypass. But there is a need for further studies since it is possible to reach different results by measuring neurocognitive functions with more sensible tests.