Efecto de propofol frente a sevoflurano en la oxigenación cerebral en la enfermedad de Moyamoya pediátrica. Estudio de espectroscopia de infrarrojo cercano

IF 0.9 Q3 ANESTHESIOLOGY Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-01-01 DOI:10.1016/j.redar.2024.03.009

J.R. Seshan, I. Kapoor, H. Prabhakar, C. Mahajan

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Abstract

Introduction and objectives

Anaesthesia during surgery for moyamoya disease (MMD) has different effects on cerebral physiology. Both sevoflurane and propofol have cerebral protective effects, albeit with different mechanisms. We used near infrared spectroscopy (NIRS) to observe the effect of sevoflurane and propofol on rSO₂ in paediatric patients undergoing MMD surgery.

Materials and methods

We included paediatric patients ASA grade I aged between 1 and 18 years undergoing surgery for MMD over a period of 1 year (from 1 April 2018 to 1 April 2019). Patients were randomized to 2 groups: Group S (sevoflurane) and Group P (propofol). NIRS values were recorded at 5 time points: T1 (baseline) T2 (after preoxygenation), T3 (after induction), T4 (end of surgery), T5 (after extubation). One-way ANOVA was used for intra-group comparisons and two-way repeated measures ANOVA with Bonferroni correction were used for inter-group comparisons. P value < 0.05 was considered significant.

Results

A total of 20 patients were included in the study. The average age was 10.5 ± 4.3 years. The mean baseline rSO₂ was 78.35 ± 10.58 and 77.95 ± 8.81 in the right and left hemispheres, respectively. In both groups, rSO₂ values increased between baseline and anaesthesia induction and fell slightly at the end of surgery. The inter-group analysis showed no statistically significant change between rSO₂ values.