• J. Oral Maxillofac. Surg. · Oct 2008

    Randomized Controlled Trial

    Nitroglycerin- and nicardipine-induced hypotension does not affect cerebral oxygen saturation and postoperative cognitive function in patients undergoing orthognathic surgery.

    • Seung Ho Choi, Sung Jin Lee, Young-Soo Jung, Yang-Sik Shin, Dong Byeong Jun, Kyung Ho Hwang, Jia Liu, and Ki Jun Kim.
    • Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
    • J. Oral Maxillofac. Surg. 2008 Oct 1;66(10):2104-9.

    PurposeThe aim of this study was to investigate the influence of nitroglycerin- and nicardipine-induced hypotension on regional cerebral oxygen saturation (rSO(2)) and postoperative cognitive function in patients undergoing orthognathic surgery.Patients And MethodsSixty adult patients scheduled for orthognathic surgery were randomly assigned to either the nitroglycerin group (group 1) or nicardipine group (group 2). After induction of anesthesia, hypotension was induced with continuous infusion of nitroglycerin or nicardipine. Mean arterial pressure (MAP), heart rate (HR), and rSO(2) were measured at the following time points: before induction of anesthesia, immediately before commencing induced hypotension, at 30 and 60 minutes after induced hypotension, and immediately before the end of surgery. Cerebral desaturation was defined as a reduction of rSO(2) less than 75% of baseline for > or = 15 seconds. The Mini Mental State Examination (MMSE) was conducted before surgery and then repeated after 1 week.ResultsBaseline rSO(2) values were similar in the 2 groups. There were no significant differences in rSO(2) values between the 2 groups. Cerebral desaturation was not observed in any of the patients. Both nitroglycerin and nicardipine reduced MAP and increased HR during induced hypotension as compared with the baseline values (P < .05). No differences in MAP and HR during baseline and induced hypotension were observed between the 2 groups. Decreased MMSE scores were not observed in any of the patients.ConclusionCerebral oxygen saturation and postoperative cognitive function were not impaired during nitroglycerin- and nicardipine-induced hypotension in patients undergoing orthognathic surgery.

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