Ligation of the internal jugular vein increased regional cerebral oxygen saturation but decreased the bispectral index in a 72-year-old man: a case report

JA Clinical Reports
Maiko Hasegawa-MoriyamaYuichi Kanmura

Abstract

Regional cerebral oxygen saturation (rSO2) and the bispectral index (BIS) are used to detect cerebral perfusion abnormalities. However, whether rSO2and BIS values change during ligation of the internal jugular vein (IJV) is unknown. We report a case in which BIS values were decreased, despite increased rSO2during ligation of the IJV. A 72-year-old man was diagnosed with metastasis of renal cancer to the thyroid associated with tumor embolism in the right IJV. Thyroidectomy with total laryngectomy was performed. After right IJV ligation, right rSO2was increased from 73 to 78 %, while the right BIS value was decreased from 40 to 27. Contralateral rSO2and BIS values were unchanged. Right rSO2and BIS values returned to pre-ligation values in 10 min. Ligation of the IJV might increase cerebral blood flow and ipsilateral rSO2. Physicians should use BIS values with caution during IJV ligation because a sudden decrease in the BIS value is not always associated with cerebral hypoperfusion.

References

Dec 24, 2004·Anesthesia and Analgesia·Yasuhiro MorimotoSatoshi Hagihira
Jan 2, 2007·Journal of Neurosurgical Anesthesiology·Vincent BonhommePol Hans
Dec 17, 2009·British Journal of Anaesthesia·J M Murkin, M Arango

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