Somatosensory evoked potential and motor evoked potential in detecting the occurrence of intraoperative cerebral ischemia in patients undergoing carotid endarterectomy / 临床麻醉学杂志

ABSTRACT

Objective To investigate the accurancy of somatosensory evoked potential (SSEP) and motor evoked potential (MEP) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing carotid endarterectomy (CEA).Methods Ninety patients (71 males, 19 females, aged 18-80 years, ASA physical status grade Ⅱ or Ⅲ) undergoing CEA using general anesthesia were studied.Bilateral SSEP and MEP were monitored during CEA and the intraoperative changes of SSEP and MEP amplitude and latency were analyzed before, during and after ICA cross-clamping until CEA ended.Neurological dysfunction was investigated within 5 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of neurological dysfunction.Results Fourteen cases (15.6%) were diagnosed as post-operative neurological dysfunction.The sensitivity, specificity of SSEP in detecting the occurrence of intraoperative brain ischemia were 79%, 92%, respectively.The sensitivity, specificity of MEP was 86%, 89% respectively.The sensitivity, specificity, of SSEP+MEP was 79%, 99% respectively.Conclusion During the carotid endarter ectomy,SSEP predicts the occurrence of cerebral ischemia with a high specificity.MEP has a high sensitivity.The combination monitoring of SSEP+MEP can improve the specificity, make up for the shortcomings of single monitoring.