Use of hypertension and electroencephalographic monitoring during carotid endarterectomy.

Intraoperative hypertension and continuous electroencephalographic (eeg) monitoring were used during 42 carotid endarterectomies performed on 37 patients from 1970 to 1978. Computer spectral analysis of a majority of the electroencephalograms was also performed. Under supplemented nitrous oxide general anesthesia, elevation of the mean arterial blood pressure to 20% above the individual's preoperative mean blood pressure resulted in reversal to normal of an ischemic EEG pattern in 19% of the patients. The authors discuss the benefit of this technique. they present guidelines for patient selection and analyse the data to help the surgeon decide whether to use shunt during carotid endarterectomy.