The Differential Effects of Prostaglandin E1 and Nitroglycerin on Regional Cerebral Oxygenation in Anesthetized Patients

Abstract

The cerebrovascular effects of vasodilators used for induced hypotension are not fully understood. In this study, we used near infrared spectrometry and jugular oxygen saturation measurement to assess the effects of prostaglandin E1 and nitroglycerin on cerebral perfusion. We found that nitroglycerin and prostaglandin E1 increase cerebral oxygen saturation as measured by near infrared spectrometry, but with different time courses. This information will hopefully help anesthesiologists to better maintain adequate regional cerebral oxygenation.

The effect of acute normovolemic haemodilution on cerebral oxygenation

“…Despite concerns regarding the clinical validity of cerebral oximetry, such as the discordance between rSO 2 and the jugular venous oxygen saturation (21) or potential extracranial contamination (22), many studies have shown that it can be used to detect cerebral hypoxia with a sensitivity comparable to jugular venous oxygen saturation (8,9,12,23) or electroencephalography (23). Accordingly, a cerebral oximetry, a non‐invasive monitoring device for cerebral tissue oxygenation was chosen in this study.…”

“…The cerebral oximetry measures the ratio of oxyhaemoglobin to total haemoglobin in the field beneath the sensor, which is represented as the percentage regional cerebral oxygen saturation (rSO 2 ). It is used widely in patients undergoing various procedures including neurosurgery and cardiac surgery because it provides real‐time information non‐invasively (8–12).…”

Balloon pump–induced pulsatile perfusion during cardiopulmonary bypass does not improve brain oxygenation

“…After the study was completed, we examined the sample size. On the basis of the variance in previous measurements of SjvO 2 , 17 the sample size provides 80% power to detect a 20% difference between groups with a 5% probability of α-type error.…”

“…28 Furthermore, other types of NIRS machines that are capable of assessing the state of mitochondrial redox in the brain are needed to estimate the degree of microcirculation. 11,17,23 The most recent reports from the Duke group suggested that a reduction in SjvO 2 has only a minor independent effect on neuropsychologic outcome. 29 However, a reduction in SjvO 2 in patients with a preexisting neurologic disorder may have great influence on neurologic outcome.…”