The effectiveness of bispectral index monitoring on carotid endarterectomy with general anesthesia Genel anestezi ile karotis endarterektomi ameliyatlarinda bispektral i̇ndeks monitorizasyonunun etkinliǧi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.19, sa.1, ss.31-36, 2013 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 19 Sayı: 1
- Basım Tarihi: 2013
- Doi Numarası: 10.5222/gkdad.2013.031
- Dergi Adı: Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.31-36
- Anahtar Kelimeler: Bispectral index, Brain ischaemia, Carotid surgery, General anesthesia, Monitoring
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Carotid endarterectomy (CE) is an established treatment in the prevention of cerebrovascular events. A stroke is the most significant perioperative risk for patients undergoing CE secondary to an embolism or carotid cross-clamping. Several cerebral monitoring techniques are available for detection of cerebral hypoperfusion and ischemia during the carotid cross-clamping. The Bispectral index (BIS) is derived from the electroencephalography and may be useful for the diagnosis of perioperative cerebral ischemia This study was aimed to investigate the BIS changes and associated neurological deficitis during carotid cross-clamping in patients under general anesthesia. Material and Methods: This study was planned prospectively for patients undergoing elective carotid surgery. Preoperative characteristics were recorded for all patients. The same general anaesthetic protocol and anaesthetic monitorization were performed for all patients. The BIS was used in all patients. BIS measurements were made and recorded at baseline, after induction, at the beginning of surgery, before cross-clamping, at the 1st, 2nd, 3rd, 5th, 7th, 10th, 15th, 17th and 20th minutes of clamping and after declamping. The relation of BIS measurements and occurrence of neurologic events were analyzed. Results: The BIS levels decreased significantly only at the 2nd and 3rd minutes after the clamping (p<0.05). However, BIS measurements increased rapidly afterwards. The BIS measurements did not increase significantly at 1st, 5th, 7th, 10th, 15th, 17th and 20th minutes after clamping. We did not observe any neurological deficit in none of the patients. Conclusion: Several cerebral monitoring modalities are available for carotid surgery. However, none of the monitorization methods of cerebral ischaemia are perfect. Anaesthesiologists should be careful in order to provide sufficient mean arterial pressure for the brain and the heart.