Role of Near Infrared Spectroscopy Monitoring in Intra-Operative Period for Neurological Outcomes in Complex Aortic Surgeries- A study of ۵۰ Adult Cases

Introduction: Complex aortic surgeries are associated with a considerable risk of perioperative neurological complications, mainly due to cerebral hypoperfusion, ischemia, or embolic events. Early recognition of cerebral oxygen imbalance during surgery may help in reducing postoperative neurological morbidity. Near-infrared spectroscopy (NIRS) offers a non-invasive method for continuous monitoring of regional cerebral oxygen saturation (rSO₂).Methods: This observational study included ۵۰ adult patients undergoing complex aortic surgery. Baseline cerebral rSO₂ values were recorded using NIRS before induction and monitored throughout the intraoperative period. Cognitive function was assessed using the Standard Mini-Mental State Examination (SMMSE) before surgery and again in the postoperative period. Intraoperative changes in NIRS values were compared with postoperative SMMSE scores to evaluate cognitive decline and delirium. Additional clinical outcomes, including duration of mechanical ventilation and length of intensive care unit stay, were also analyzed.Results: A fall in intraoperative cerebral rSO₂ was associated with a reduction in postoperative SMMSE scores, indicating postoperative cognitive decline in a subset of patients. Patients with lower intraoperative NIRS values also showed a tendency toward prolonged ventilation and longer intensive care unit (ICU) stay. Postoperative cognitive dysfunction was observed in approximately ۱۰% of the study population.Conclusion: Intraoperative NIRS monitoring may be a useful adjunct in complex aortic surgeries for detecting cerebral desaturation and identifying patients at risk of postoperative cognitive dysfunction. Reduced rSO₂ values were associated with poorer neurological recovery, prolonged ventilation, and increased ICU stay.

کلیدواژه ها:

Aortic Aneurysm ، cognitive dysfunction ، Intraoperative Monitoring ، Ischemia ، Near-infrared ، Spectroscopy