Arnold G, Kluger M, Voss L, Sleigh J
Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Takapuna, Auckland, New Zealand.
Anaesthesia. 2007 Sep;62(9):907-12. doi: 10.1111/j.1365-2044.2007.05149.x.
The interaction of many poorly defined, physiological, pharmacological, and pathological factors make titration of general anaesthesia in the elderly difficult. There may be a potential clinical benefit using the processed electroencephalogram (EEG) to monitor hypnotic level in this population. We prospectively studied 16 patients aged over 65 years having hip fractures repaired under general anaesthesia by experienced anaesthetists blinded to Bispectral Index (BIS(XP)) and Entropy values. Pre-induction EEG indices did not correlate with age or mini-mental state examination (MMSE). During maintenance of anaesthesia, BIS(XP) and Response Entropy (RE) values were within the recommended range of 40-60, 45% and 32% of the total time, respectively. BIS(XP) and Response Entropy (RE) values were above 60 for 11% and 13% of the total time, respectively, and below 40 for 44% and 55% of the total time, respectively. BIS(XP) correlated well with RE in 12 patients, but in the other four patients there was a difference of more than 20 points between BIS(XP) and RE.
许多定义不明确的生理、药理和病理因素相互作用，使得老年人全身麻醉的滴定变得困难。对于这一人群，使用处理后的脑电图（EEG）监测催眠水平可能具有潜在的临床益处。我们前瞻性地研究了16例65岁以上在全身麻醉下接受髋部骨折修复手术的患者，由对脑电双频指数（BIS(XP)）和熵值不知情的经验丰富的麻醉师进行操作。诱导前的脑电图指标与年龄或简易精神状态检查表（MMSE）无关。在麻醉维持期间，BIS(XP)和反应熵（RE）值分别在40 - 60的推荐范围内的时间占总时间的45%和32%。BIS(XP)和反应熵（RE）值分别在总时间的11%和13%时高于60，分别在总时间的44%和55%时低于40。12例患者的BIS(XP)与RE相关性良好，但在其他4例患者中，BIS(XP)与RE之间的差异超过20个点。
