Correlation of Cerebral Oxygen Saturation Change with Perioperative Complications in Elderly Patients Who Underwent...

Laparoscopic partial hepatectomy is a crucial treatment for primary liver cancer but is associated with risks such as bleeding and organ hypoperfusion due to controlled low central venous pressure (CLCVP). Regional cerebral oxygen saturation (rSO₂), measured using near-infrared spectroscopy (NIRS), serves as a reliable indicator of cerebral perfusion. This study aims to investigate the relationship between intraoperative rSO₂ changes, perioperative outcomes, and neurological complications.

This retrospective study analyzed 218 elderly patients undergoing laparoscopic partial hepatectomy, grouped based on intraoperative rSO₂ reductions of ≥10% and ≥20%. Perioperative complications were assessed. Serum neuron-specific enolase (NSE) levels were measured on postoperative day 3 via enzyme-linked immunosorbent assay. Hemodynamic parameters, including mean arterial pressure (MAP), were monitored intraoperatively.

Among the 218 patients, significant rSO₂ reductions were linked to higher risks of neurological complications. Patients with ≥20% rSO₂ reductions had increased incidences of delirium (30.5% vs 13.0%, p = 0.002), and elevated serum NSE levels (p < 0.05). Declines in MAP during critical intraoperative periods were associated with rSO₂ reductions. Patients with marked rSO₂ drops also experienced prolonged hospital stays.

Intraoperative rSO₂ reductions, especially >20%, are linked to adverse neurological outcomes and delayed recovery. Combined rSO₂ and NSE monitoring offers a robust strategy to optimize cerebral perfusion and improve outcomes.