Correlation of Regional Cerebral Blood Flow (rCBF) with EEG Changes During Isoflurane Anesthesia for Carotid Endarterectomy

Messick, Joseph M.; Casement, B.; Sharbrough, Frank W.; Milde, Leslie Newberg; Michenfelder, John D.; Sundt, Thoralf M.

doi:10.1097/00000542-198703000-00014

Cited by 136 publications

(30 citation statements)

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“…100 g-i .min-l). 226 Michenfelder et al, from their retrospective study of 2010 carotid endarterectomies performed using inhalationai anaesthesia, with EEG and CBF monitoring, reached the same conclusion. The critical CBF was 10 ml.…”

Section: Anaesthesiamentioning

confidence: 69%

Perioperative stroke Part I: General surgery, carotid artery disease, and carotid endarterectomy

Wong

1991

Can J Anaesth

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Section: Anaesthesiamentioning

confidence: 69%

Perioperative stroke Part I: General surgery, carotid artery disease, and carotid endarterectomy

Wong

1991

Can J Anaesth

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“…[14][15][16] Néanmoins, du fait de son nombre réduit d'électrodes de mesure, le BIS ne permet pas une analyse globale de l'activité élec-tro-encéphalographique. Une ischémie survenant dans une région très circonscrite et à distance des électrodes n'aura que peu d'effets sur la valeur globale du BIS.…”

Section: Discussionunclassified

“…Cependant la sensibilité du BIS dans cette indication n'est pas parfaite. [14][15][16] D'autres auteurs proposent d'employer le BIS afin de détecter des événements étrangers à l'anesthésie ou pour ajuster un traitement sans rapport direct avec l'anesthésie. 1 7 À partir de plusieurs cas cliniques que nous avons observés nous allons montrer que le BIS peut ne pas être qu'un moyen de surveillance de la profondeur de l'anesthésie.…”

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Intérêt potentiel du BIS pour détecter une souffrance cérébrale importante

Mérat

Lévecque

Gulluche

et al. 2001

Can J Anesth/J Can Anesth

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“…The monitors that are readily available include raw and processed electroencephalogram (EEG) analysis, 4 somatosensory evoked potentials (SSEPs), 5 Doppler flowmetry, 6 cerebral oximetry, 7 cerebral blood flow, 4,8 and assessment of measureable arterial to jugular venous differences (e.g., partial pressure of oxygen, carbon dioxide, glucose, lactate, and derived indices such as oxygen content). 9 Jugular venous blood sampling is a simple intervention during carotid endarterectomy, as the jugular vein is in the surgical field and direct retrograde cannulation is easily feasible.…”

Section: Résumémentioning

confidence: 99%

Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors

Espenell

McIntyre

Gulati

et al. 2010

Can J Anesth/J Can Anesth

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Purpose The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a series of point-of-care monitors and lactate flux during CEA. Methods Both neurosurgeons and vascular surgeons participated in the study. The patients underwent arterialjugular venous blood sampling for oxygen, carbon dioxide, glucose, and lactate, n = 26; bispectral index (BIS) monitoring ipsilateral to side of surgery, n = 26; raw and processed electroencephalogram (EEG), n = 22; and bi-frontal cerebral oximetry using the Fore-Sight monitor, n = 20. Results One patient experienced a new neurological deficit when assessed at 24 hr following surgery. Lactate flux into the brain was correlated with the greatest decrease in cerebral oximetry with carotid cross-clamping; lactate efflux was correlated with the least. The most noticeable changes in processed EEG (density spectral analysis) were also seen with lactate influx, but at a slower time resolution than cerebral oximetry. Loss of autoregulatory behaviour was demonstrated with lactate influx; however, no correlation was seen between lactate flux and BIS monitoring. Conclusion There was a correlation between cerebral oximetry and lactate flux during carotid cross-clamping. The Fore-Sight monitor may be of value as a point-of-care monitor during CEA under general anesthesia. A novel finding of this study is lactate flux into the brain in the presence of a large difference in cerebral oxygenation during cross-clamping of the carotid artery. Registered at clinicaltrials.gov: NCT000737334. RésuméObjectif La capacite´d'e´valuer le cerveau a`risque pendant une endarte´riectomie carotidienne (EC) sous anesthe´sie ge´ne´rale demeure un proble`me clinique important. Le monitorage au chevet pourrait potentiellement conduire ad es modifications de la prise en charge perope´ratoire. Dans cette e´tude observationnelle, nous avons explore´la corre´lation entre une se´rie de moniteurs au chevet et le flux de lactate pendant une EC. Méthode Des neurochirurgiens et des chirurgiens vasculaires ont pris part a`cette e´tude. Les patients ont subi un e´chantillonnage du sang veineux arte´riel jugulaire pour de´tecter les concentrations d'oxyge`ne, de dioxyde de carbone, de glucose et de lactate, n = 26; monitorage par index bispectral (BIS) ipsilate´ral au côte´de la chirurgie, n = 26; e´lectroence´phalogramme (EEG) brut et apre`s

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Correlation of Regional Cerebral Blood Flow (rCBF) with EEG Changes During Isoflurane Anesthesia for Carotid Endarterectomy

Cited by 136 publications

References 0 publications

Perioperative stroke Part I: General surgery, carotid artery disease, and carotid endarterectomy

Perioperative stroke Part I: General surgery, carotid artery disease, and carotid endarterectomy

Intérêt potentiel du BIS pour détecter une souffrance cérébrale importante

Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors

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