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  • Title: Somatosensory evoked potentials versus locoregional anaesthesia in the monitoring of cerebral function during carotid artery surgery: preliminary results of a prospective study.
    Author: Sbarigia E, Schioppa A, Misuraca M, Panico MA, Battocchio C, Maraglino C, Speziale F, Fiorani P.
    Journal: Eur J Vasc Endovasc Surg; 2001 May; 21(5):413-6. PubMed ID: 11352515.
    Abstract:
    OBJECTIVE: to relate changes in somatosensory-evoked potentials (SEPs) with onset of neurological deficits in patients having carotid endarterectomy (CEA) under locoregional anaesthesia. METHODS: a prospective study of 50 consecutive patients. RESULTS: SEPs yielded an accuracy of 98%, specificity 100%, and sensitivity 89%. In all concordant cases the onset of a neurological deficit in awake patients corresponded to a 30--40% reduction in amplitude of N20-P25 waveforms. After shunting, the N20-P25 took 2--3 min to return to normal. CONCLUSIONS: SEPs are associated with a 2% false negative rate. Their threshold for detecting cerebral ischaemia is lower than the currently reported value for patients under general anaesthesia. The time needed for evoked potentials (2--3 min) to return to normal after shunting limits their usefulness in verifying effective shunting.
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