Comparison of the processed electroencephalogram and awake neurological assessment during carotid endarterectomy

A processed electroencephalogram (EEG) produced by the Lifescan monitor (Neurometrics), was compared to awake neurological assessment for detecting cerebral ischaemia in seventy patients undergoing carotid endarterectomy under cervical plexus block. Of the six patients demonstrating neurological sig...

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Bibliographic Details
Published in:Anaesthesia and intensive care 1989-08, Vol.17 (3), p.298-304
Main Authors: SILBERT, B. S, KOUMOUNDOUROS, E, DAVIES, M. J, CRONIN, K. D
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brain Ischemia - diagnosis
Carotid Arteries - surgery
Cerebrovascular Circulation
Electroencephalography - methods
Endarterectomy
Humans
Hypotension - physiopathology
Intraoperative Complications - diagnosis
Intraoperative Period
Medical sciences
Neurologic Examination
Neurosurgery
Skull, brain, vascular surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Wakefulness
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Summary:A processed electroencephalogram (EEG) produced by the Lifescan monitor (Neurometrics), was compared to awake neurological assessment for detecting cerebral ischaemia in seventy patients undergoing carotid endarterectomy under cervical plexus block. Of the six patients demonstrating neurological signs on cross-clamping the carotid, five displayed simultaneous EEG changes, four being detected during surgery, and one being detected after reviewing the EEG postoperatively. Another four patients displayed EEG changes indicative of ischaemia but unassociated with neurological signs. A further patient displayed contralateral intraoperative EEG changes. Hypotension resulted in one EEG change and two cases were associated with technical difficulties with the monitor. The presence of false negatives, possible false positives, technical errors and subjective interpretation associated with the processed EEG make it less reliable than awake neurological assessment for the detection of cerebral ischaemia.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X8901700310