Journal of Clinical Monitoring and Computing

, Volume 30, Issue 5, pp 655–660 | Cite as

Effect of controlled hypotension on regional cerebral oxygen saturation during rhinoplasty: a prospective study

  • Ali Fuat Erdem
  • Gurkan Kayabasoglu
  • Ayca Tas TunaEmail author
  • Onur Palabiyik
  • Yakup Tomak
  • Serbulent Gokhan Beyaz
Original Research


The aim of this study was to investigate the effect of controlled hypotension on cerebral oxygen saturation (rSO2) using near infrared spectroscopy (NIRS) and evaluation of postoperative cognitive function in patients undergoing rhinoplasty. Fifty adult patients who were scheduled for elective rhinoplasty surgery and required controlled hypotension were enrolled in this prospective study. Controlled hypotension was provided using a combination of propofol and remifentanil infusion supplemented with nitroglycerin infusion as necessary. rSO2 was evaluated during controlled hypotension by NIRS. Cerebral desaturation was observed in 5 out of 50 patients (10 %) during hypotensive anesthesia. The greatest decrease from baseline was 28 % when MAP was 57 mmHg. In both non-desaturated and desaturated patients, postoperative MMSE scores were significantly lower than preoperative scores. There was a 4 % decrease in the non-desaturated patients and a 7 % decrease in the desaturated patients when preoperative and postoperative MMSE scores were compared. A decline in cognitive function 1 day after surgery was observed in 23 patients (46 %) and in all patients with intraoperative cerebral desaturation. The current study showed that even if SpO2 is in the normal range, there might be a decrease of more than 20 % in cerebral oxygen saturation during controlled hypotension.


Controlled hypotension Near infrared spectroscopy Cerebral oxygen saturation Rhinoplasty 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Ali Fuat Erdem
    • 1
  • Gurkan Kayabasoglu
    • 2
  • Ayca Tas Tuna
    • 1
    Email author
  • Onur Palabiyik
    • 3
  • Yakup Tomak
    • 1
  • Serbulent Gokhan Beyaz
    • 1
  1. 1.Department of Anesthesiology, Faculty of MedicineSakarya UniversitySakaryaTurkey
  2. 2.Department of Otorhinolaryngology, Faculty of MedicineSakarya UniversitySakaryaTurkey
  3. 3.Department of AnesthesiologySakarya University Training and Research HospitalSakaryaTurkey

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