Protocol for electrophysiological monitoring of carotid endarterectomies

作     者：Hong Liu Anthony M Di Giorgio Eric S Williams William Evans Michael J Russell 

作者机构：Department of Anesthesiology University of CaliforniaDavis Medical CenterSacramentoCA 95817USA Active DiagnosticsInc.DavisCA 95616USA Kaiser Permanente Sacramento Medical CenterSacramentoCA 95825USA Aaken LaboratoriesInc.DavisCA 95616USA 

出 版 物：《The Journal of Biomedical Research》 (生物医学研究杂志（英文版）)

年 卷 期：2010年第24卷第6期

页      面：460-466页

学科分类：082803[工学-农业生物环境与能源工程] 08[工学] 0828[工学-农业工程] 0804[工学-仪器科学与技术] 0803[工学-光学工程] 

主　　题：intraoperative monitoring somatosensory evoked potentials electroencephalogram carotid endarterectomy carotid 

摘      要：Near zero stroke rates can be achieved in carotid endarterectomy （CEA） surgery with selective shunting and electrophysiological *** false negative rates as high as 40% have been *** sought to determine if improved training for interpretation of the monitoring signals can advance the efficacy of selective shunting with electrophysiological monitoring across multiple centers,and determine if other factors could contribute to the differences in *** and raw beta band （12.5-30 Hz） electroencephalogram （EEG） and median and tibial nerve somatosensory evoked potentials （SSEP） were monitored in 668 CEA cases at six surgical centers.A decrease in amplitude of 50% or more in any EEG or SSEP channel was the criteria for shunting or initiating a neuroprotective protocol.A reduction of 50% or greater in the beta band of the EEG or amplitude of the SSEP was observed in 150 *** patient showed signs of a cerebral infarct after *** shunting based on EEG and SSEP monitoring can reduce CEA intraoperative stroke rate to a near zero level if trained personnel adopted standardized *** also found that the rapid administration of a protective stroke protocol by attending anesthesiologists was an important aspect of this success rate.