The effect of continuous propofol versus dexmedetomidine infusion on regional cerebral tissue oxygen saturation during cardiopulmonary bypass

download PDF

DOI: http://dx.doi.org/10.2478/rjaic-2019-0003

Ayman A. Metry, Noha S. Hussain, George M. Nakhla, Milad Z. Ragaei, Ramy M. Wahba

Anaesthesia Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Background: Cerebral oxygen desaturation can arise during various durations of cardiopulmonary bypass (CBP), thus continuous monitoring is necessary. This desaturation may account for distinct neuropsychological deficits. Near-infrared spectrophotometry (NIRS) is a non-invasive method that offers many advantages for monitoring cerebral oxygenation.
Objectives: The aim of this study was to compare the outcome of propofol and dexmedetomidine on cerebral regional oxygen saturation (rScO2) during CPB and on postoperative cognitive dysfunction.
Patients and Methods: 50 patients anticipated for open heart surgeries were encompassed in the study. Patients were divided into 2 groups, group P (receiving propofol) and group D (receiving dexmedetomidine) during CPB. Both groups were studied for variations in right and left rScO2 as well as postoperative cognitive dysfunction using the Mini Mental State Examination Score (MMSE) test.
Results: The results showed no significant difference in both groups of the study, with an increase in rScO2 on the right and left side in T1 compared to T0 and maximum increase in T3-4-5, then a decrease in T6-7. With regard to the cognitive dysfunction there was a decrease in the values at 1 h in both groups without significant difference; after 1 week MMSE values returned to baseline values.
Conclusion: Propofol and dexmedetomidine infusion used during CPB preserve the rScO2 and do not affect the neurological outcome.
Keywords: cerebral oxygen saturation, cardiopulmonary bypass, dexmedetomidine, propofol