Median nerve somatosensory evoked potential monitoring during carotid endarterectomy-report of one case

Carotid endarterectomy was performed on a 64 y/o female patient who had been suffering from multiple transient ischemic attacks caused by the stenosis of right common carotid artery at its bifurcation. Median nerve somatosensory evoked potential (SSEP) was utilized for monitoring cerebral function during and after operation. Latency, amplitude and central conduction time (CCT) of bilateral N13 (CV2) and N20 (C3', C4') were measured as an aid for management of anesthesia, surgical procedure and postoperative care. The results showed SSEP which is sensitive for detection of cerebral ischemia and could help the surgeon and anesthesiologist maintaining optimal cerebral perfusion, but yields little information about postoperative hyperperfusion state. Besides evaluating the efficacy of SSEP, we discussed the problems encountered during the SSEP monitoring.