Schmidt Gunter N, Bischoff Petra, Standl Thomas, Voigt Moritz, Papavero Luca, Schulte am Esch Jochen
Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Anesth Analg. 2002 Nov;95(5):1324-30, table of contents. doi: 10.1097/00000539-200211000-00042.
The aim of this study was to investigate modern and classical electroencephalographic (EEG) variables in response to remifentanil and propofol infusions. We hypothesized that modern EEG variables may indicate the effects of propofol but not of remifentanil. Twenty-five patients were included in the study after the end of elective spine surgery without any surgical stimulation. Baseline values were defined with remifentanil 0.3 microg. kg(-1). min(-1) and target-controlled infusion of propofol 3.0 microg/mL. EEG changes were evaluated 1, 3, 5, 7, and 9 min after the stop of remifentanil infusion, followed by a step-by-step reduction (0.2 microg/mL) every 3 min of target-controlled infusion propofol. Narcotrend (NT; classifying EEG stages from awake to deep anesthesia), bispectral index (BIS), EEG spectral frequency bands (%), 50% (Median) and 95% percentiles (spectral edge frequency), mean arterial blood pressure, heart rate, and oxygen saturation were detected at every time point. The end of remifentanil application resulted in significant increases in %alpha, spectral edge frequency, mean arterial blood pressure, and %theta and decreases in %delta (P < 0.05). NT, BIS, Median, heart rate, and oxygen saturation were unchanged. Decreases in propofol concentration were associated with statistically significant increases in NT and BIS (P < 0.05). Thus, the sedative-hypnotic component of propofol could be estimated by modern EEG variables (NT and BIS), whereas the analgesic component provided by remifentanil was not indicated. However, during conditions without surgical stimulation, neither NT nor BIS provided an adequate assessment of the depth of anesthesia when a remifentanil infusion was used.
We investigated modern and classical electroencephalographic (EEG) variables during emergence from propofol/remifentanil anesthesia. Modern EEG variables indicate changes of infusion in propofol, but not in remifentanil. Thus, modern EEG variables did not provide an adequate assessment of depth of anesthesia when remifentanil was used.
本研究旨在探讨现代和经典脑电图（EEG）变量对瑞芬太尼和丙泊酚输注的反应。我们假设现代EEG变量可能指示丙泊酚的作用，但不指示瑞芬太尼的作用。25例患者在择期脊柱手术后结束且无任何手术刺激时纳入本研究。基线值定义为瑞芬太尼0.3微克·千克⁻¹·分钟⁻¹和丙泊酚靶控输注3.0微克/毫升。在停止输注瑞芬太尼后1、3、5、7和9分钟评估EEG变化，随后每3分钟将丙泊酚靶控输注逐步降低（0.2微克/毫升）。在每个时间点检测脑电意识深度监测（NT；将EEG阶段从清醒分类到深度麻醉）、脑电双频指数（BIS）、EEG频谱频段（%）、50%（中位数）和95%百分位数（频谱边缘频率）、平均动脉血压、心率和血氧饱和度。应用瑞芬太尼结束后，%α、频谱边缘频率、平均动脉血压和%θ显著增加，%δ降低（P<0.05）。NT、BIS、中位数、心率和血氧饱和度无变化。丙泊酚浓度降低与NT和BIS的统计学显著增加相关（P<0.05）。因此，丙泊酚镇静催眠成分可通过现代EEG变量（NT和BIS）估计，而瑞芬太尼提供的镇痛成分未显示。然而，在无手术刺激的情况下，当使用瑞芬太尼输注时，NT和BIS均未对麻醉深度提供充分评估。
我们研究了丙泊酚/瑞芬太尼麻醉苏醒期间的现代和经典脑电图（EEG）变量。现代EEG变量指示丙泊酚输注的变化，但不指示瑞芬太尼输注的变化。因此，当使用瑞芬太尼时，现代EEG变量未对麻醉深度提供充分评估。
