Cerebral hemodynamic changes and electroencephalography during carotid endarterectomy

Journal Article · Tue May 01 04:00:00 EDT 1990 · Journal of Clinical Anesthesia; (USA)

DOI:https://doi.org/10.1016/0952-8180(90)90088-K· OSTI ID:6704648

Algotsson, L; Messeter, K; Rehncrona, S; Skeidsvoll, H; Ryding, E ^[1]

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1. University Hospital, Lund (Sweden)

Some patients undergoing endarterectomy for occlusive carotid artery disease run a risk of brain ischemia during cross-clamping of the artery. The present study of 15 patients was undertaken to evaluate changes in cerebral blood flow (CBF), as measured with an intravenous (IV) tracer (133Xenon) technique, and to relate CBF changes to changes in the electroencephalogram (EEG). CBF was measured before and after induction of anesthesia, during cross-clamping of the carotid artery, after release of the clamps, and at 24 hours after the operation. All the patients were anesthetized with methohexitone, fentanyl, and nitrous oxide and oxygen. EEG was continuously recorded during the operation. Carotid artery shunts were not used. In 8 patients, cross-clamping of the carotid artery did not influence the EEG. In this group of patients, induction of anesthesia caused a 38% decrease in CBF, which presumably reflects the normal reaction to the anesthetic agent given. There were no further changes in CBF during cross-clamping. In 7 patients, the EEG showed signs of deterioration during the intraoperative vascular occlusion. In these patients, anesthesia did not cause any CBF change, whereas cross-clamping the artery induced a 33% decrease in CBF. In individual patients, the severity of EEG changes correlated with the decrease in CBF. The absence of a change in CBF by anesthesia and a decrease due to cross-clamping of the carotid artery may be explained by the presence of a more advanced cerebrovascular disease and an insufficiency to maintain CBF during cross-clamping.

• OSTI ID: 6704648
• Journal Information: Journal of Clinical Anesthesia; (USA), Journal Name: Journal of Clinical Anesthesia; (USA) Journal Issue: 3 Vol. 2:3; ISSN JCLBE; ISSN 0952-8180
• Country of Publication: United States
• Language: English

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