Thiopentone cerebral protection under EEG control during carotid endarterectomy.
Seventy patients who underwent a total of 77 consecutive carotid endarterectomies were given thiopentone (mean dose 19 mg/kg) under EEG control for cerebral protection during the period of carotid clamping. This technique was used instead of elective insertion of a temporary bypass shunt in response to adverse EEG changes occurring after clamping. The EEG was monitored continuously throughout operation. The EEG burst-suppression pattern with electrically inactive periods of 30-60 seconds was taken as indicating a depth of barbiturate anaesthesia adequate to provide brain protection. Patients exhibited a drop in blood pressure during barbiturate administration: in most the pressure recovered spontaneously but in twenty operations metaraminol was needed to re-establish an adequate pressure before clamping. No adverse cardiological effects were associated with the administration of thiopentone or metaraminol. There was no mortality and no neurological morbidity in this series.
D000368:Aged; D001794:Blood Pressure; D001921:Brain / Q000187:drug effects*; D002339:Carotid Arteries / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D004569:Electroencephalography; D004691:Endarterectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000517:prevention & control; D013874:Thiopental / Q000494:pharmacology*
D013874:Thiopental