Abstract: Objective To assess the effect of aggressive blood pressure management on regional cerebral oxygen saturation (rSO₂) of patients undergone carotid endarterectomy (CEA).Methods A total of 20 patients, aged from 49 to 75 years old, undergone CEA were included in the study. The baseline for MAP was calculated the day before surgery. The strategy of aggressive blood pressure management include that MAP was kept at baseline value during preclamp phase, elevated 10%-20% of baseline value during cross-clamp phase with SBP no more than 160 mmHg (1 mmHg=0.133 kPa) and then decreased 10%-20% of baseline value after clamp removal. Intraoperative bispectral index (BIS), rSO₂ monitoring were applied. The value of MAP, BIS and rSO₂ were recorded at different points of the surgery. Results The MAP was elevated about 11% of baselinevalue during clamping phase (P<0.05) and decreased about 11% of baseline value after clamp removal (P<0.05). The rSO₂ value detected from ipsilateral brain was significantly decreased during the cross-clamp phase (P<0.05), but the decreasing percentage in rSO₂ was less than 20% from preclamp value to cross-clamp value. Then, the rSO₂ was ameliorated to baseline value after clamp removal. Conclusion Aggressive blood pressure management is beneficial to improve rSO₂ for the patients undergoing CEA and prevent incidence of cerebral ischemia.

Key words: carotid endarterectomy, regional cerebral oxygen saturation (rSO₂), cerebral ischemia, blood pressure management