Background. In the past decade, near-infrared spectroscopy has gained popularity in neonatal wards. Taking into account modern international experience, the presented work assesses the features of cerebral oximetry in children with surgical congenital malformations under various types of combined anesthesia. The purpose of the study was to assess the state of cerebral oxygenation in newborns and infants with congenital malformations in various types of anesthetic support. Materials and methods. A retrospective study included 150 newborns and infants with surgical congenital malformations, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous and total intravenous anesthesia). The parameters of cerebral oximetry were analyzed in comparison with peripheral saturation, blood pressure, partial pressure of CO2, O2 in the blood, and pH. Results. The minimum index of cerebral oximetry was observed in the left brain hemisphere of children in group I — 50.57 ± 16.66 that may be an unfavorable prognostic factor for further recovery and influence on the cognitive functions of the brain. One hour after the operation, the children of the first group, who received combined anesthesia with sevorane and regional anesthesia, showed the worse indicators of cerebral oximetry compared to groups II and III (rSO2 of the right hemisphere in the first group — 56.84 ± 12.27, rSO2 of the left hemisphere in the first group — 57.53 ± 13.32, p = 0.0001; 0.0028), while the differences in this indicator between groups II and III were not found (p = 0.4167; 0.4029). Conclusions. Near-infrared spectroscopy has proven to be a simple, feasible and useful method for monitoring the oxygen saturation of the brain. When choosing a combined anesthesia by inhalation and regional anesthesia in children with congenital malformations for surgical treatment, cerebral oxygenation should be more carefully monitored with additional control of peripheral saturation, blood pressure, partial pressure of CO2, O2 in the blood and pH.
Early hyperoxia burden detected by cerebral near-infrared spectroscopy is superior to pulse oximetry for prediction of severe retinopathy of prematurity
