選択的脳分離体外循環中にregional oxygen saturationは変動なくneurological pupil indexが低下した1例  [in Japanese] A Case of Decreased Neurological Pupil Index with No Change in rSO<sub>2</sub> during Selective Cerebral Perfusion  [in Japanese]

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Abstract

<p>瞳孔記録計(NPi-200,NeuroOptics社)の独自の指標であるNPi(neurological pupil index)は瞳孔対光反射を評価し第Ⅱ/Ⅲ脳神経を介した脳幹部の機能を表す.本症例では選択的脳分離体外循環中,左鎖骨下動脈の灌流を外科的吻合のために停止した.その際に前額部のrSO<sub>2</sub>(regional oxygen saturation)の低下はなくNPiのみが0となった.今回,右椎骨動脈狭窄症例であり,左鎖骨下動脈の灌流を停止した際に脳底動脈の灌流も低下した可能性がある.その間,rSO<sub>2</sub>は変化なくNPiのみが低下した.NPiは脳底動脈領域の灌流異常を検知できる可能性がある.</p>

<p>We encountered a patient whose Neurological Pupil index(NPi)decreased to zero without change in rSO<sub>2</sub> when perfusion in the left subclavian artery was stopped for anastomosis during selective cerebral perfusion. INVOS<sup>TM</sup>(Covidien, Boulder, CO, US)is mainly attached on the forehead and rSO<sub>2</sub> represents the local oxygen saturation. Because of these characteristics, it is reportedly unsuitable for detecting decreased perfusion in the basilar artery region. In contrast, NPi, an independent indicator of a pupil recorder(NPi<sup>®</sup>-200, NeuroOptics), objectively evaluates the pupillary light reflex and represents the function of the brain stem through the cranial nerves II and III. In the present case, stenosis of the right vertebral artery was originally present. Perfusion of the basilar artery was believed to have decreased when perfusion of the left subclavian artery was stopped for anastomosis. At that time, only NPi decreased. We report that NPi could be used to monitor perfusion of the basilar artery region.</p>

Journal

  • THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA

    THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 39(3), 257-262, 2019

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

Codes

  • NII Article ID (NAID)
    130007665021
  • Text Lang
    JPN
  • ISSN
    0285-4945
  • Data Source
    J-STAGE 
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