Bispectral index monitoring may not reliably indicate cerebral ischaemia during awake carotid endarterectomy

British Journal of Anaesthesia

Volumn 94, Issue 6, 2005, Pages 800-804

  Deogaonkar, A ^a   Vivar, R ^b   Bullock, R E ^b   Price, K ^b   Chambers, I ^b   Mendelow, A D ^b  

^a LERNER RESEARCH INSTITUTE   (United States)

^b NEWCASTLE GENERAL HOSPITAL   (United Kingdom)

Author keywords

Brain; Ischaemia; Monitoring, bispectral index; Surgery, endarterectomy

Indexed keywords

ADRENALIN; BUPIVACAINE; LIDOCAINE; OXYGEN;

ADULT; AGED; ARTERY CLAMP; ARTICLE; BISPECTRAL INDEX; BRAIN INFARCTION; BRAIN ISCHEMIA; CAROTID ENDARTERECTOMY; CORRELATION ANALYSIS; DIAGNOSTIC VALUE; ELECTROENCEPHALOGRAM; FEMALE; GLASGOW COMA SCALE; HUMAN; INCISION; MAJOR CLINICAL STUDY; MALE; MUSCLE STRENGTH; NERVOUS SYSTEM PARAMETERS; NEUROLOGIC EXAMINATION; PATIENT MONITORING; PRIORITY JOURNAL; RELIABILITY;

EID: 19944384934     PISSN: 00070912     EISSN: None     Source Type: Journal    
DOI: 10.1093/bja/aei115     Document Type: Article

References (42)

1. Anonymous. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 1998; 351: 1379-87
2. Barnett HJ, Taylor DW, Eliasziw M, et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med 1998; 339: 1415-25
3. Halliday A, Mansfield A, Marro J, et al. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet 2004; 363: 1491-1502
4. Anonymous. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 1995; 273: 1421-8
5. Thompson JE. Carotid endarterectomy, 1982 - the state of the art. Br J Surg 1983; 70: 371-6
6. McKinsey JF, Desai TR, Bassiouny HS, et al. Mechanisms of neurologic deficits and mortality with carotid endarterectomy. Arch Surg 1996; 131: 526-31
7. Hafner CD, Evans WE. Carotid endarterectomy with local anesthesia: results and advantages. J Vasc Surg 1988; 7: 232-9
8. Cho I, Smullens SN, Streletz LJ, Fariello RG. The value of intraoperative EEG monitoring during carotid endarterectomy. Ann Neurol 1986; 20: 508-12
9. Myers RR, Stockard JJ, Saidman LJ. Monitoring of cerebral perfusion during anesthesia by time-compressed Fourier analysis of the electroencephalogram. Stroke 1977; 8: 331-7
10. Prokop A, Meyer GP, Walter M, Erasmi H. Validity of SEP monitoring in carotid surgery. Review and own results. J Cardiovasc Surg (Torino) 1996; 37: 337-42
11. Hirofumi O, Otone E, Hiroshi I, et al. The effectiveness of regional cerebral oxygen saturation monitoring using near-infrared spectroscopy in carotid endarterectomy. J Clin Neurosci 2003; 10: 79-83
12. Finocchi C, Gandolfo C, Carissimi T, Del Sette M, Bertoglio C. Role of transcranial Doppler and stump pressure during carotid endarterectomy. Stroke 1997; 28: 2448-52
13. O2, probe as a guide to selective shunting. Physiol Meas 2003; 24: 347-54
14. Dunne VG, Besser M, Ma WJ. Transcranial Doppler in carotid endarterectomy. J Clin Neurosci 2001; 8: 140-5
15. Ackerstaff RG, Moons KG, van de Vlasakker CJ, et al. Association of intraoperative transcranial doppler monitoring variables with stroke from carotid endarterectomy. Stroke 2000; 31: 1817-23
16. Findlay JM, Marchak BE, Pelz DM, Feasby TE. Carotid endarterectomy: a review. Can J Neurol Sci 2004; 31: 22-36
17. Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology 1998; 89: 980-1002
18. Merat S, Levecque JP, Le Gulluche Y, Diraison Y, Brinquin L, Hoffmann D. [BIS monitoring may allow the detection of severe cerebral ischemia.] Can J Anaesth 2001; 48: 1066-9
19. Welsby IJ, Ryan JM, Booth JV, Flanagan E, Messier RH, Borel CO. The bispectral index in the diagnosis of perioperative stroke: a case report and discussion. Anesth Analg 2003; 96: 435-7
20. Illig KA, Sternbach Y, Zhang R, et al. EEG changes during awake carotid endarterectomy. Ann Vasc Surg 2002; 16: 6-11
21. Silbert BS, Koumoundouros E, Davies MJ, Cronin KD. Comparison of the processed electroencephalogram and awake neurological assessment during carotid endarterectomy. Anaesth Intensive Care 1989; 17: 298-304
22. Silbert BS, Kluger R, Cronin KD, Koumoundouros E. The processed electroencephalogram may not detect neurologic ischemia during carotid endarterectomy. Anesthesiology 1989; 70: 356-8
23. Win NN, Kohase H, Miyamoto T, Umino M. Decreased bispectral index as an indicator of syncope before hypotension and bradycardia in two patients with needle phobia. Br J Anaesth 2003; 91: 749-52
24. Sundt TM Jr, Sharbrough FW, Piepgras DG, Kearns TP, Messick JM Jr, O'Fallon WM. Correlation of cerebral blood flow and electroencephalographic changes during carotid endarterectomy: with results of surgery and hemodynamics of cerebral ischemia. Mayo Clin Proc 1981; 56: 533-43
25. Jansen C, Moll FL, Vermeulen FE, van Haelst JM, Ackerstaff RG. Continuous transcranial Doppler ultrasonography and electroencephalography during carotid endarterectomy: a multimodal monitoring system to detect intracoperative ischemia. Ann Vasc Surg 1993; 7: 95-101
26. Kearse LA Jr, Martin D, McPeck K, Lopez-Bresnahan M. Computer-derived density spectral array in detection of mild analog electroencephalographic ischemic pattern changes during carotid endarterectomy. J Neurosurg 1993; 78: 884-90
27. McFarland HR, Pinkerton JA Jr, Frye D. Continuous electroencephalographic monitoring during carotid endarterectomy. J Cardiovasc Surg (Torino) 1988; 29: 12-18
28. Pinkerton JA Jr. EEG as a criterion for shunt need in carotid endarterectomy. Ann Vasc Surg 2002; 16: 756-61
29. Plestis KA, Loubser P, Mizrahi EM, Kantis G, Jiang ZD, Howell JF. Continuous electroencephalographic monitoring and selective shunting reduces neurologic morbidity rates in carotid endarterectomy. J Vasc Surg 1997; 25: 620-8
30. Ashburn MA, Mitchell LB, Dean DF, String ST, Callahan A. The power spectrum analyser as an indicator of cerebral ischaemia during carotid endarterectomy. Anaesth Intensive Care 1985; 13: 387-91
31. Tempelhoff R, Modica P, Grubb R Jr, Rich K. Early detection of cerebral ischaemia by computerized EEG monitoring. Results during 132 carotid endarterectomies. J Cardiothorac Anesth 1989; 3: 72
32. Tempelhoff R, Modica PA, Grubb RL Jr, Rich KM, Holtmann B. Selective shunting during carotid endarterectomy based on two-channel computerized electroencephalographic/compressed spectral array analysis. Neurosurgery 1989; 24: 339-44
33. De Deyne C, Struys M, Decruyenaere J, Creupelandt J, Hoste E, Colardyn F. Use of continuous bispectral EEG monitoring to assess depth of sedation in ICU patients. Intensive Care Med 1998; 24: 1294-8
34. Simmons LE, Riker RR, Prato BS, Fraser GL. Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale. Crit Care Med 1999; 27: 1499-1504
35. Triltsch AE, Welte M, von Homeyer P, et al. Bispectral index-guided sedation with dexmedetomidine in intensive care: a prospective, randomized, double blind, placebo-controlled phase II study. Crit Care Med 2002; 30: 1007-14
36. el Dawlatly AA. EEG bispectral index during carotid endarterectomy. Middle East J Anesthesiol 2003; 17: 287-93
37. Hayashida M, Chinzei M, Komatsu K, et al. Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery. Br J Anaesth 2003; 90: 694-8
38. Hayashida M, Kin N, Tomioka T, et al. Cerebral ischaemia during cardiac surgery in children detected by combined monitoring of BIS and near-infrared spectroscopy. Br J Anaesth 2004; 92: 662-9
39. Morimoto Y, Monden Y, Ohtake K, Sakabe T, Hagihira S. The detection of cerebral hypoperfusion with bispectral index monitoring during general anesthesia. Anesth Analg 2005; 100: 158-61
40. Umegaki N, Hirota K, Kitayama M, Yatsu Y, Ishihara H, Mtasuki A. A marked decrease in bispectral index with elevation of suppression ratio by cervical haematoma reducing cerebral perfusion pressure. J Clin Neurosci 2003; 10: 694-6
41. van Alphen HA, Polman CH. The value of continuous intraoperative EEG monitoring during carotid endarterectomy. Acta Neurochir (Wien) 1988; 91: 95-9
42. Kearse LA Jr, Lopez-Bresnahan M, McPeck K, Zaslavsky A. Preoperative cerebrovascular symptoms and electroencephalographic abnormalities do not predict cerebral ischemia during carotid endarterectomy. Stroke 1995; 26: 1210-14