Niinai H, Nakagawa I, Shima T, Kawamoto M, Yuge O
Department of Anesthesia, Chugoku Rosai General Hospital, Hiroshima, Japan.
Hiroshima J Med Sci. 1998 Dec;47(4):133-7.
In this study we examined whether continuous monitoring of jugular bulb venous oxygen saturation (SjO2) is applicable for the evaluation of cerebral hypoperfusion during carotid endarterectomy (CEA). The subjects were 25 patients who underwent elective CEA under general anaesthesia. After the carotid stump pressure (SP) was measured, SjO2 and the somatosensory evoked potentials (SEP) were monitored during the carotid test clamping for 10 min. There was no alteration in cardiovascular and respiratory status during the test clamping. No correlation was observed between SEP amplitude and SP (r = 0.16, p = 0.25). However, at clamping, SjO2 decreased from 70 to 64% (p < 0.01) with a reduction in SEP amplitude from 2.0 to 1.6 microV (p < 0.01). After declamping, SjO2 increased from 65 to 70% (p < 0.01) with a recovery in SEP from 1.6 to 1.9 microV (p < 0.01). The changes in SEP amplitude and SjO2 correlated (r = 0.66, p < 0.001). These results suggest that continuous monitoring of SjO2 is superior to SP measurement in the prediction of cerebral hypoperfusion caused by carotid clamping and applicable to CEA.
在本研究中，我们检测了颈静脉球部血氧饱和度（SjO2）的连续监测是否适用于评估颈动脉内膜切除术（CEA）期间的脑灌注不足。研究对象为25例在全身麻醉下接受择期CEA的患者。在测量颈动脉残端压力（SP）后，在颈动脉试验夹闭10分钟期间监测SjO2和体感诱发电位（SEP）。试验夹闭期间心血管和呼吸状态无改变。未观察到SEP波幅与SP之间存在相关性（r = 0.16，p = 0.25）。然而，在夹闭时，SjO2从70%降至64%（p < 0.01），SEP波幅从2.0微伏降至1.6微伏（p < 0.01）。松开夹闭后，SjO2从65%升至70%（p < 0.01），SEP从1.6微伏恢复至1.9微伏（p < 0.01）。SEP波幅和SjO2的变化具有相关性（r = 0.66，p < 0.001）。这些结果表明，在预测颈动脉夹闭引起的脑灌注不足方面，SjO2的连续监测优于SP测量，且适用于CEA。
