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Related Experiment Videos

EEG changes during awake carotid endarterectomy.

Karl A Illig1, Yaron Sternbach, Renyu Zhang

  • 1Division of Vascular Surgery, University of Rochester Medical Center, NY 14642, USA. karl_illig@URMC.rochester.edu

Annals of Vascular Surgery
|March 21, 2002
PubMed
Summary
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Regional anesthesia for carotid endarterectomy (CEA) showed fewer electroencephalographic (EEG) changes compared to general anesthesia. Cervical block may offer cerebroprotection during CEA surgery.

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Neurology

Background:

  • Carotid endarterectomy (CEA) requires careful anesthetic management to prevent cerebral ischemia.
  • Shunt rates differ between general and regional anesthesia, but the underlying reasons are not fully understood.
  • Electroencephalography (EEG) and neurologic monitoring are used to assess brain function during CEA.

Purpose of the Study:

  • To compare electroencephalographic (EEG) and neurologic changes during CEA under regional (cervical block) versus general anesthesia.
  • To investigate the relationship between anesthetic technique and shunt rates.
  • To determine if cervical block offers cerebroprotective benefits.

Main Methods:

  • A retrospective analysis of 135 patients undergoing CEA under cervical block and 288 patients under general anesthesia with EEG monitoring.

Related Experiment Videos

  • Simultaneous EEG tracings and neurologic status were compared.
  • Shunt decisions were based on neurologic changes in the regional anesthesia group.

    • Main Results:

    • EEG changes occurred in 7.4% of awake patients versus 15.3% of anesthetized patients (p < 0.03).
    • No awake patients had global EEG changes during clamping, compared to 3.5% under general anesthesia (p < 0.04).
    • Global EEG changes correlated with blood pressure variability, suggesting an anesthetic-related effect.

    Conclusions:

    • Global EEG changes during CEA may be influenced by the anesthetic technique, not solely cerebral ischemia.
    • Cervical block anesthesia appears to be associated with fewer global EEG changes during CEA.
    • Regional anesthesia, specifically cervical block, may provide cerebroprotective effects during CEA.