Somatosensorisch evozierte Potenziale und biochemische Marker neuronaler Defizite während Endarterektomie der A. carotis in Regionalanästhesie

Abstract

Compared to SEP, CEA under regional anaesthesia is a safer method to detect patients with cerebral ischaemia before irreversible cellular brain damage occurs. Measuring blood levels of S-100 beta could help to evaluate patients with risk to develop cerebral ischaemia during clamping.

Impact of General Versus Local Anesthesia on Early Postoperative Cognitive Dysfunction Following Carotid Endarterectomy: GALA Study Subgroup Analysis

“…The main limitation of our study was the absence of any standardized neuromonitoring in patients undergoing GA. With regard to the limited specificity and sensitivity of any neuromonitoring method [10, 39], the indication for shunting was surgeon‐specific and represents the standard care of clinical practice in many surgical departments.…”

“…These clinical strategies include, among others, recordings of somatosensory evoked potentials or carotid artery stump pressure, electroencephalography, and transcranial Doppler sonography [7][8][9]. However, it has been shown that none of these methods reached the sensitivity and specificity of neuromonitoring in awake patients undergoing local anesthesia (LA) [10,11]. Continuous communication with patients and retaining control of their motor functions allow an early, interference-free, economical identification of neurologic deficiencies.…”

Intermediate Cervical Plexus Block for Carotid Endarterectomy: A Case Series of the Spread of Injectate

“…The known methods of neurological monitoring during general anesthesia show poor sensitivity and specificity, compared with the awake patient, in terms of the requirement for shunt placement [ 2 , 3 ].…”

Ultrasound-guided carotid sheath block for carotid endarterectomy surgery in a high-risky patient and literature review

“…[1,2] The important point is that ischemic complications may occur during the surgery. [4,5] Thus, the central nervous system monitoring should be performed to improve the safety. [4] The awakeness of the patient is more effective method than the monitoring methods.…”

“…[4,5] Thus, the central nervous system monitoring should be performed to improve the safety. [4] The awakeness of the patient is more effective method than the monitoring methods. [4,5] Hence, regional anesthesia techniques may be performed instead of general anesthesia for shunt placement during CEA surgery.…”