Background: The monitoring of regional cerebral oxygen saturation (SrO2) using near-infrared spectroscopy is useful\nmethod to detect cerebral ischemia during. Sevoflurane and propofol decrease cerebral metabolic rate (CMRO2) in a\nsimilar manner, but the effects on the cerebral blood flow (CBF) are different. We hypothesized that the effects of\nsevoflurane and propofol on SrO2 were different in patients with deficits of CBF. This study compared the effect of\nsevoflurane and propofol on SrO2 of patients undergoing cerebral endarterectomy (CEA).\nMethod: Patients undergoing CEA were randomly assigned to the sevoflurane or propofol group (n = 74). The\nexperiment was preceded in 2 stages based on carotid artery clamping. The first stage was from induction of\nanaesthesia to immediately before clamping of the carotid artery, and the second stage was until the end of the\noperation after clamping of the carotid artery. Oxygen saturation (SrO2, SpO2), haemodynamic variables (blood\npressure, heart rate), respiratory parameters (end-tidal carbon dioxide tension, inspired oxygen tension), concentration\nof anesthetics, and anesthesia depth (bispectral index score) were recorded.\nResults: During stage 1 period (before carotid artery clamping), the mean value of the relative changes in SrO2 was\nhigher (P = 0.033) and the maximal decrease in SrO2 was lower in the sevoflurane group compared with the propofol\ngroup (P = 0.019) in the contralateral (normal) site. However, there is no difference in ipsilateral site (affected site). SrO2\ndecreased after carotid artery clamping and increased after declamping, but the difference was not significant between\ntwo groups. Changes in mean arterial blood pressure was lower in sevoflurane group than propofol group after the\ncarotid artery declamping (P = 0.048).\nConclusion: Propofol-remifentanil anesthesia was comparable with sevoflurane-remifentanil anesthesia in an aspect of\npreserving the SrO2 in patients undergoing carotid endarterectomy.
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