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Protocol for electrophysiological monitoring of carotid endarterectomies

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The Journal of Biomedical Research 2010年第6期24卷 460-466页

作者： Hong Liu Anthony M Di Giorgio Eric S Williams William Evans Michael J Russell Department of Anesthesiology University of California Davis Medical CenterSacramentoCA 95817USA Active Diagnostics Inc.DavisCA 95616USA Kaiser Permanente Sacramento Medical Center SacramentoCA 95825USA Aaken Laboratories Inc.DavisCA 95616USA

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.

关键词： intraoperative monitoring somatosensory evoked potentials electroencephalogram carotid endarterectomy carotid

THE APPLICATION OF CORTICAL SOMATOSENSORY EVOKED POTENTIAL monitoring IN CHILD SCOLIOSIS SURGERY

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Journal of Pharmaceutical Analysis 2003年第1期15卷 59-61页

作者：白斌王坤正同志勤刘文科宋金辉袁国莲 Department of Orthopaedics Department of Surgery

Objective To study the application value of cortical somatosensory evoked potential (CSEP) monitoring in child scoliosis surgery. Methods In surgeries of fifty one children with scoliosis, the CSEP changes were continuously recorded by evoked potential instrument. The operations were performed under the guidance of CSEP monitoring. Results Before propping and reshaping, the latencies and amplitudes in all cases had no change. During propping and reshaping, the latencies of all cases were slowly elongated, but all less than 10 percent. The amplitudes in 15 cases dropped to 55 percent, but returned to 80 percent 3-8 minutes after stopping the operations or partially loosening the propped rods at once. The amplitude in one case suddenly dropped to 37 percent and returned to 54 percent half an hour after loosening the propped rods at once and recovered to the normal range one day after operation. All cases got ideal orthopedic results and no one had neurological complications post operation. Conclusion CSEP can accurately monitor the spinal injury and has a great value in preventing the spinal injury in child scoliosis surgery.

关键词： child scoliosis evoked potential intraoperative monitoring

Value of somatosensory evoked potentials in diagnosis, surgical monitoring and prognosis of cervical spondylotic myelopathy

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Chinese Medical Journal 2008年第15期121卷 1374-1378页

作者： DING Yu HU Yong RUAN Di-ke CHEN Bo Department of Orthopaedics Navy General Hospital Beijing 100037 China Department of Orthopaedics and Traumatology University of Hong Kong the Duchess of Kent Children's Hospital Hong Kong China

Background The value of somatosensory evoked potentials （SEPs） in the diagnosis and prognosis of cervical spondylotic myelopathy, as well as the usefulness of monitoring intraoperative potentials in terms of safety and predictive factors were investigated. Methods Each of the 76 myelopathic patients underwent surgical intervention. According to the wave configurations of the SEPs, the cases were categorised into four groups： Type Ⅰ, Ⅱ, Ⅲ and Ⅳ. The clinical myelopathy disability was classified and the severity of neurological deficits was scored. Clinical function after surgery was evaluated. Preoperative potentials and intraoperative monitoring were categorized. The correlations between .evoked potentials detection, monitoring, myelopathy disability and surgical outcome in the different groups were discussed. Results According to the configurations of the SEPs, there were 27 patients （36%） of Type Ⅰ, 30 patients （39%） of Type Ⅱ, 8 patients （11%） of Type Ⅲ, and 11 patients （14%） of Type Ⅳ. The categorised evoked potentials were shown to be significantly associated with the clinical representation of myelopathy （P 〈0.01） and the recovery rate from identifiable SEPs waves （groups A, B and C） was significantly higher than unidentifiable waves （group D, P〈0.01）. A deterioration of SEPs was detected in 23 cases （30%）, whereas there was no change in 40 cases （53%） and improvements in 13 cases （17%）. A significant difference in recovery rates could be observed in various monitoring groups within the short-term follow-up period, while there were no obvious differences in the long-term follow-up groups. Conclusions SEP technique is a valuable and practical tool for the diagnosis, monitoring and prognosis of myelopathy. Classified evoked potentials are well correlated with cervical spondylotic myelopathy disability, and unidentifiable SEPs waves in patients are indicative of a relatively poor outcome. In addition, intraoperative monitoring of SEPs plays an important role in p

关键词： somatosensory evoked potentials intraoperative monitoring cervical spondylotic myelopathy surgery

intraoperative LOCALIZATION OF CORTICAL MOTOR EVOKED POTENTIALS IN CENTRAL SULCUS LESIONS

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Journal of Shanghai Second Medical University(Foreign Language Edition) 2007年第2期19卷 100-103页

作者：费智敏丁赵琦张珏崔华李学民周彩芳书国伟周正文王勇 Department of Neurosurgery Renji Hospital School of Medicine Shanghai Jiaotong University

Objective To study direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia in central sulcus lesions. Methods The largest N20-P25 response was recorded from postcentral gyrus by intraoperative monitoring of cortical motor evoked potentials in 10 patients with intracranial lesions near or in the central area. The muscles of upper extremity in all patients were activated by delivering stimulus to cortical areas continuously. Moving the cortical electrodes forward, the largest P20-N25 response, SEP phase reversal,was obtained as a motor center stimulus. In this site of cortex, a short train stimulation elicited reproducible muscle action potentials that could be observed from the oscilloscope without *** MEPs can be recorded, pre-and post-operatively, without motor deficits of upper limbs in all *** This technique seems to be preferable for intraoperative localization of motor evoked potentials in central sulcus lesions under total intravenous anesthesia.

关键词： intraoperative monitoring motor evoked potentials transcortical stimulation train stimulation central sulcus lesions

Evaluation of extracranial–intracranial bypass patency for moyamoya disease using intraoperative MRI

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Evaluation of extracranial–intracranial bypass patency for ...