Change in Brain Perfusion During Induction of General Anesthesia

Arterial hypotension during general anesthesia remains a factor of poor outcomes, increases the risk of myocardial infarction, acute kidney injury and 1-year mortality. Furthermore, arterial hypotension may also decrease cerebral perfusion contributing to worsen neurological outcome. It seems necessary to monitor cerebral perfusion during anesthesia and to define individual dynamic targets of blood pressure. The goal of this study is to evaluate cerebral perfusion change in adult patients with or without cardiovascular risk factors during a standardized propofol-remifentanil anesthesia induction. Cerebral perfusion will be evaluated and compared by simultaneous measurements of cerebral blood flow, cerebral oxygen saturation and neurological function with use of transcranial Doppler (TCD), Near infrared spectroscopy (NIRS) and the Bispectral index (BIS) monitoring, respectively. Those measurements will be also repeated during and after treatment of arterial hypotension episodes in both groups.

Inclusion Criteria: * Major patients (≥ 18 years old) * Eligible for an interventional radiology procedure or orthopedic surgery under general anesthesia. * Patients who expressed their non-opposition to participation in this research Exclusion Criteria: * Patients under the age of 18. * Patient opposed to participation in the protocol * Pregnant woman * Patient under judicial protection measure * Patient without affiliation to a social security scheme-