Evaluation of Cognitive Functions by Cerebral Pulse Oximetry
Study Details
Study Description
Brief Summary
General and Spinal Anesthesia can be used in geriatric patients in orthopedic surgery. Post-op cognitive dysfunction can be seen in orthopedic surgeries in this group of patients.
In this study, the investigators aimed to compare cognitive functions between spinal and general anesthesia using cerebral and systemic oxygenation, hemodynamic data and pre-op, post-op cognitive function tests.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Cerebral Oximeter is a monitoring application based on the measurement of regional oxygen saturation by transcutaneous route by near infrared spectroscopy technology. With this system that analyzes the intraparenchymal and microcirculation in the frontal cortex, cerebral oxygenation changes caused by possible hypoxemia are followed. Unlike pulse oximeter, it works in non-pulsatile conditions. In other words, continuous, real-time and safe oxygen saturation is continued to be measured even in the case of cardiopulmonary arrest. It is a significant advantage of noninvasive measurement according to jugular venous oxygen saturation measurement. For normal healthy people, the accepted normal range is 58-82%, while 0 to 15% of measurements are important for providing CPR process information.
Oxygen saturation measured by cerebral oximetry is different from that measured by other oxygen saturation measurement techniques. The main reason for this is the technique itself and the region where it is used. The radiation emitted by the cerebral oximetry sensor is aimed at the microvessel structure with venous and arterial mix. Since the contribution of venous and arterial blood volume in this structure is between 70-75% and 30-25%, different results are obtained based on only arterial or just venous bed measurements. In this sense, the measured saturation value is lower than the arterial oxygen and pulse oximetry saturation values; higher than venous values.
The ratio of oxyhemoglobin to the total hemoglobin below the region under evaluation of the system is expressed as, value in% System and reflected to the user as Regional Oxygen Saturation (rSO2). There are publications that can be used not only for cerebral but also for different tissues (ischemic limb, kidney, etc.).
General and Spinal Anesthesia can be used in geriatric patients in orthopedic surgery. Post-op cognitive dysfunction may be seen in orthopedic surgery in this patient group. There are not enough studies showing the correlation of cognitive functions with cerebral pulse oximetry after general and spinal anesthesia. In this study, the investigators aimed to compare cognitive functions between spinal and general anesthesia using cerebral and systemic oxygenation, hemodynamic data and pre-op, post-op cognitive function tests.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Spinal anesthesia Evaluation of cognitive functions of patients under 65 years of age with lower extremity surgery by cerebral pulse oximetry |
Other: cerebral pulse oximetry
Cognitive Functions by Cerebral Pulse Oximetry After General Anesthesia and Spinal Anesthesia
Other Names:
|
| General anesthesia Evaluation of cognitive functions of patients under 65 years of age with lower extremity surgery by cerebral pulse oximetry |
Other: cerebral pulse oximetry
Cognitive Functions by Cerebral Pulse Oximetry After General Anesthesia and Spinal Anesthesia
Other Names:
|
Outcome Measures
Primary Outcome Measures
- mini-mental testing [preoperative and postoperative 48 hours mini-mental test change]
pre-op and post-op mini-mental testing
- cerebral pulse oxymetry value [change in peroperative cerebral pulse oxymetry value]
peroperative cerebral pulse oxymetry value
Secondary Outcome Measures
- peripheral oxygen saturation [1 min before induction, 1 min after induction or sedation, at surgical incision, 15 min of surgery, 30 min of surgery, 45 min of surgery, 60 min of surgery, leaving the operation room, at recovery and post-op 48 hours]
peripheral oxygen saturation
- Heart rate [1 min before induction, 1 min after induction or sedation, at surgical incision, 15 min of surgery, 30 min of surgery, 45 min of surgery, 60 min of surgery, leaving the operation room, at recovery and post-op 48 hours]
Heart rate
- systolic blood pressure [1 min before induction, 1 min after induction or sedation, at surgical incision, 15 min of surgery, 30 min of surgery, 45 min of surgery, 60 min of surgery, leaving the operation room, at recovery and post-op 48 hours]
systolic blood pressure
- diastolic blood pressure [1 min before induction, 1 min after induction or sedation, at surgical incision, 15 min of surgery, 30 min of surgery, 45 min of surgery, 60 min of surgery, leaving the operation room, at recovery and post-op 48 hours]
diastolic blood pressure
- hemoglobin value [before 24 hours and after 24 hours of surgery]
hemoglobin value
Eligibility Criteria
Criteria
Inclusion Criteria:
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ASA 1-2
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patients with lower extremity surgery
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Cognitive functions sufficient
Exclusion Criteria:
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Brain functions affected
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Peri-operative MAP <60 ones
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Those with electrolyte dysfunctions
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Those who need more blood and blood transfusion
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Patients with ASA 3 and above
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | İzmir Tepecik TRH | İzmir | Turkey |
Sponsors and Collaborators
- Tepecik Training and Research Hospital
Investigators
- Principal Investigator: Fatih Mehmet Kurt, MD, Tepecik Train and Research Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Guo JY, Fang JY, Xu SR, Wei M, Huang WQ. Effects of propofol versus sevoflurane on cerebral oxygenation and cognitive outcome in patients with impaired cerebral oxygenation. Ther Clin Risk Manag. 2016 Jan 18;12:81-5. doi: 10.2147/TCRM.S97066. eCollection 2016.
- Jo YY, Kim JY, Lee MG, Lee SG, Kwak HJ. Changes in cerebral oxygen saturation and early postoperative cognitive function after laparoscopic gastrectomy: a comparison with conventional open surgery. Korean J Anesthesiol. 2016 Feb;69(1):44-50. doi: 10.4097/kjae.2016.69.1.44. Epub 2016 Jan 28.
- Kok WF, van Harten AE, Koene BM, Mariani MA, Koerts J, Tucha O, Absalom AR, Scheeren TW. A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass*. Anaesthesia. 2014 Jun;69(6):613-22. doi: 10.1111/anae.12634. Epub 2014 Apr 22.
- Papadopoulos G, Karanikolas M, Liarmakopoulou A, Papathanakos G, Korre M, Beris A. Cerebral oximetry and cognitive dysfunction in elderly patients undergoing surgery for hip fractures: a prospective observational study. Open Orthop J. 2012;6:400-5. doi: 10.2174/1874325001206010400. Epub 2012 Sep 3.
- Fatih Mehmet Kurt