Cerebral oxygen desaturation monitored by intraoperative near-infrared spectroscopy, and incidence of post-operative cognitive dysfunction: a systematic review protocol

Abstract

Review question/objective The objective of this systematic review is to determine if there is a direct relationship between cerebral oxygen desaturation using intraoperative near-infrared spectroscopy monitoring, and the incidence of post-operative cognitive dysfunction (POCD). Inclusion criteria Types of participants This systematic review will consider all patients over the age of eight years old receiving general anesthesia for any surgical procedure, since patients younger than this age usually have different anesthetic emergence and transfer processes than patients older than eight years of age. Patients with pre-existing neurologic disease including stroke, alcohol abuse, history of psychiatric disorders, and emergency cases will be excluded, since a baseline neurologic test cannot be performed appropriately. Focus of the review The systematic review considers studies that examine the use of NIRS or cerebral oximetry as a monitor for cerebral oxygen saturation and desaturation in patients receiving general anesthesia. Types of outcomes The systematic review will consider studies that included measurements of postoperative neurological deficit, and POCD related to cerebral oxygen desaturation as outcome measures. This cognitive decline is measured throughout the literature with various tools including the (MMSE), this test measures neurocognitive functions such as orientation, attention, and calculation, memory and language. Another tool is the Logical Memory Subtest of the Rivermead, which examines the immediate and delayed memory as well as the recovery capacity. Other tools include The Rey Auditory Verbal Learning Test and The Verbal Fluency Test and others. 8