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Assessment of cerebral oxygen supply-demand balance by near-infrared spectroscopy during induction of anesthesia in patients undergoing coronary artery bypass graft surgery: comparison of midazolam with propofol

Authors
 Dae-Hee Kim  ;  Young Lan Kwak  ;  Soon Ho Nam  ;  Min-Soo Kim  ;  Eun-Mi Kim  ;  Jae-Kwang Shim 
Citation
 Korean Journal of Anesthesiology, Vol.57(4) : 428-433, 2009 
Journal Title
 Korean Journal of Anesthesiology 
ISSN
 0302-5780 
Issue Date
2009
Abstract
BACKGROUND: Near-infrared spectroscopy (NIRS) continuously measures regional cerebral oxygen saturation (rSO2) noninvasively and has been shown to detect even small changes in cerebral oxygen supply-demand balance. Although widely used, only the effect of midazolam on cerebral blood flow has been studied in humans and evidence is lacking about its effect on cerebral metabolic rate. We therefore evaluated the effect of midazolam on cerebral oxygen supply-demand balance with NIRS. METHODS: Sixty patients undergoing elective coronary artery bypass graft surgery were randomly allocated into either midazolam (n = 30) or propofol (n = 30) group. rSO2 was recorded before induction while patients were breathing room air as baseline, after pre-oxygenation with 100% oxygen, after administration of either midazolam or propofol, after completion of administration of sufentanil and after tracheal intubation. Hemodynamic variables including cardiac index and mixed venous oxygen saturation were recorded at the same time points. RESULTS: rSO2 and hemodynamic variables were similar between the groups throughout the study period. After pre-oxygenation, rSO2 significantly increased compared to baseline in each group, and did not show any additional increase after administration of either midazolam or propofol and sufentanil in both groups. CONCLUSIONS: Midazolam preserves cerebral blood flow-metabolism coupling to a similar degree to propofol as assessed by near infrared spectroscopy
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
곽영란(Kwak, Young Lan) ORCID logo https://orcid.org/0000-0002-2984-9927
김민수(Kim, Min Soo) ORCID logo https://orcid.org/0000-0001-8760-4568
김은미(Kim, Eun Mi)
남순호(Nam, Soon Ho)
심재광(Shim, Jae Kwang) ORCID logo https://orcid.org/0000-0001-9093-9692
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106034
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