Emergence cerebral oxygen desaturation without hemodyna mic compromise in pediatric patients

Background: The regional cerebral oxygen saturation (rSO₂) decreases significantly during ordinary anesthetic recovery in pediatric patients anesthetized with sevoflurane or desflurane. The present study examined the relationship between rSO₂ and the clinical parameters associated with the degree of anesthetic recovery. Methods: Twelve pediatric patients with American Society of Anesthesiologists physical status 1 were assigned randomly to receive anesthesia with sevoflurane or desflurane. All children underwent general anesthesia for minor surgery. After surgery, the rSO₂, the age-adjusted MAC fraction of anesthetic concentration (F_E), and the bispectral index (BIS) were recorded over a 10-minute period. The correlations between rSO₂ and candidate predictors, such as F_E, BIS, anesthetic, and duration of anesthesia, were analyzed. Results: All children recovered uneventfully. The lowest observed rSO₂ reached 63% and the maximum decrease in rSO₂ was 24%. The mean blood pressure and heart rate were maintained within clinical ranges. The decrease in rSO₂ correlated positively with the F_E (r = 0.25, P = 0.00) and the duration of anesthesia (r = 0.24, P = 0.01), and inversely with the use of sevoflurane (r = -0.30, P = 0.00). Conclusions: Despite normal parameters, cerebral desaturation occurred during the emergence of ordinary general anesthesia even without hemodynamic compromise or arterial desaturation. Cerebral desaturation might be associated with the degree of anesthetic recovery and the use of sevoflurane.