EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

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Original Article
Effects of controlled hypotension on regional cerebral oxygen saturation and cognitive function in hypertensive patients undergoing tympanoplasty
Abstract
Aims: Controlled hypotension may impair tissue perfusion and inhibit autonomic regulation, potentially increasing the risk of cerebral ischemia in patients with hypertension due to altered autoregulation. This study aimed to compare the effects of controlled hypotension on regional cerebral oxygen saturation (rSO²) and cognitive function in hypertensive and normotensive patients undergoing tympanoplasty.
Methods: Sixty patients (ASA physical status I–II, aged 18–63 years) scheduled for elective tympanoplasty were enrolled in this prospective study. Patients were allocated into two groups: normotensive (Group N, n=30) and hypertensive (Group H, n=30). Demographic characteristics, hemoglobin and hematocrit levels, anesthesia and surgical durations, time to extubation, total remifentanil consumption, additional analgesic requirements, and hemodynamic variables were recorded. Bilateral rSO² values (near-infrared spectroscopy), bispectral index (BIS), end-tidal carbon dioxide (EtCO²), body temperature, and inspired/expired sevoflurane concentrations were recorded at 5-minute intervals intraoperatively. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) 24 hours preoperatively and at postoperative 6 and 24 hours.
Results: After achieving target blood pressure, mean arterial pressure values were comparable between groups. Although hypertensive patients demonstrated greater reductions in blood pressure from baseline, rSO² values did not differ significantly between groups. No patient developed postoperative cognitive dysfunction based on MMSE scores at 6 or 24 hours. The incidence of adverse events was similar between groups.
Conclusion: Within a defined mean arterial pressure range, controlled hypotension did not result in decreased regional cerebral oxygen saturation or postoperative cognitive dysfunction in hypertensive patients. These findings suggest that controlled hypotension may be safely applied in this patient population.

Keywords : Near-infrared spectroscopy, controlled hypotension, cognitive dysfunction

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Article available in :
Volume 3, Issue 2, 2026
Page : 15-22
https://doi.org/10.51271/EAJAIC-0052
Article Information
Received : 27 Şub 2026
Accepted : 13 May 2026
Published : 16 May 2026
Corresponding Author :

Hatice Ayça Sarıbudak: Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara,Turkiye

[email protected]
Citation : Akel CY, Geçer S, Sarıbudak HA. Effects of controlled hypotension on regional cerebral oxygen saturation and cognitive function in hypertensive patients undergoing tympanoplasty. Eur J Anesthesiol Intens Care. 2026;3(2):41-48. doi:10.51271/EAJAIC-0052

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