Why is it important to begin monitoring EEG early during a carotid endarterectomy?

Beginning EEG monitoring early during a carotid endarterectomy is crucial for capturing baseline activity as well as post-induction changes that occur under general anesthesia. Recording the EEG before anesthesia allows the clinician to establish a reference point for normal brain activity specific to the patient, which is essential for detecting any deviations that might arise during the procedure due to factors such as cerebral ischemia or embolism.

Once the patient is put under anesthesia, various medications can alter brain wave patterns, which may obscure the interpretation of any significant changes during the surgery itself. Having a pre-induction recording enables more accurate comparisons to be made during the operation, enhancing the ability to detect any adverse neurological events, such as those arising from compromised blood flow or embolic phenomena.

This comprehensive approach to monitoring maximizes patient safety and informs clinical decisions throughout the surgery, reinforcing the importance of early EEG monitoring in this context.