# Cerebral Near-Infrared Spectroscopy: A Viable Tool in an Anesthesiologist’s Armamentarium for Pediatric Head and Neck Surgeries

## TL;DR

This paper discusses the use of near-infrared spectroscopy to monitor brain oxygen levels in a child during head and neck surgery, showing it can help preserve cerebral function.

## Contribution

The paper highlights the potential of NIRS as a valuable tool in pediatric head and neck surgeries for monitoring cerebral perfusion.

## Key findings

- Intraoperative NIRS monitoring showed only a minor (<10%) drop in cerebral oxygenation during tumor manipulation.
- NIRS can serve as a surrogate for cerebral perfusion in pediatric head and neck surgeries.
- Children are vulnerable to physiological changes during surgery, making cerebral function preservation crucial.

## Abstract

Near-infrared spectroscopy (NIRS) is a noninvasive monitor used regularly in pediatric cardiac surgeries to monitor regional cerebral oxygenation (rScO2). A significant intraoperative cerebral desaturation (>20% from baseline) has been reported with poor neurological outcomes. We describe a case of a six-year-old child with carotid sheath neuroblastoma, located at the carotid bifurcation posted for tumor excision. Intraoperative NIRS monitoring revealed only a transient and insignificant (<10%) fall in the rScO2 during the tumor manipulation, ensuring uninterrupted cerebral circulation. The pediatric population is vulnerable to various physiological changes during anesthesia and surgery, and conserving cerebral function is one of the major goals. Though NIRS has been researched in various surgical specialties, future emphasis must be laid on its use in pediatric head and neck surgeries as a surrogate for cerebral perfusion.