Bein Berthold
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105 Kiel, Germany.
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):101-9. doi: 10.1016/j.bpa.2005.07.009.
The concept of entropy, originally derived from thermodynamics, has been successfully applied to EEG analysis. Various entropy algorithms have been used in clinical studies, but until now a commercially available monitor exists only for spectral entropy. By calculating two distinct values for the EEG dominated part of the spectrum (state entropy, SE) and the total spectrum (response entropy, RE), the M-Entropy module claims to provide useful information regarding the cortical state of the patient as well as an indirect measure of adequacy of analgesia. Generally, entropy has been studied for quantification of anaesthetic drug effect for various GABA-ergic i.v. induction agents and volatile anaesthetics like propofol and sevoflurane and overall was found comparable to the current clinical gold standard bispectral index (BIS). Entropy guidance may not be used during ketamine or nitrous oxide administration, since there is no reliable correlation to the patient's state of consciousness. The usefulness of RE as a surrogate for increased EMG activity due to painful stimulation has not been proven so far.
熵的概念最初源于热力学,现已成功应用于脑电图(EEG)分析。各种熵算法已用于临床研究,但迄今为止,市面上仅有一款用于监测频谱熵的设备。通过计算脑电图频谱中占主导部分的两个不同值(状态熵,SE)和整个频谱的值(反应熵,RE),M-熵模块声称能够提供有关患者皮质状态的有用信息,以及间接衡量镇痛效果的指标。一般来说,人们已经对熵进行了研究,以量化各种γ-氨基丁酸(GABA)能静脉诱导剂和挥发性麻醉剂(如丙泊酚和七氟烷)的麻醉药物效果,总体而言,发现其与当前临床金标准脑电双频指数(BIS)相当。在使用氯胺酮或氧化亚氮期间,可能无法使用熵引导,因为其与患者意识状态之间不存在可靠的相关性。到目前为止,反应熵作为因疼痛刺激导致肌电图(EMG)活动增加的替代指标的有效性尚未得到证实。