Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study

Abstract

Aim:To compare the effect of bupivacaine and bupivacaine/fentanyl combination on cerebral oxygenation values with the Near-infrared spectroscopy (NIRS) technique in elective cesarean sections performed under spinal anesthesia.Methods:Fifty patients who underwent cesarean section under spinal anesthesia were randomly divided into two groups. 7.5-10 mg 0.5% hyperbaric bupivacaine was administered to the bupivacaine group (n=25) and 7.5-10 mg 0.5% hyperbaric bupivacaine+20-25 mcg fentanyl was given to the combination group (n=25). Heart rate, mean arterial pressure, peripheral oxygen saturation, mean values of regional cerebral oxygen saturation after spinal anesthesia were recorded preoperatively and the 1st, 5th, 10th, 15th and 20th minutes after anesthesia. The presence of perioperative nausea and vomiting was assessed with the Verbal Descriptive Scale.Results:Significant difference was observed in mean arterial pressure values between groups (p=0.001). There was a statistically significant change in cerebral oxygenation values during surgery in both groups (p=0.001). The frequency of nausea and vomiting was lower in the combination group (p=0.009).Conclusion:The non-invasive NIRS technique can be safely applied in the monitoring of cerebral oxygenation and hemodynamics in elective cesarean section procedures undergoing spinal anesthesia.

Keywords

• pregnancy
• sesarean section
• spinal anesthesia
• cerebral oxygenation
• intraoperative monitoring
• near-infrared spectroscopy