婴幼儿麻醉及苏醒过程中的脑电图

The electroencephalograph during anesthesia and emergence in infants and children.

作者信息

Davidson Andrew J, Sale Steven M, Wong Connie, McKeever Stephen, Sheppard Suzette, Chan Zeke, Williams Chris

机构信息

Department of Anaesthesia & Pain Management, Royal Children's Hospital, Melbourne, Australia.

出版信息

Paediatr Anaesth. 2008 Jan;18(1):60-70. doi: 10.1111/j.1460-9592.2007.02359.x.

DOI:10.1111/j.1460-9592.2007.02359.x

PMID:18095968

Abstract

BACKGROUND

The characteristics of the electroencephalogram (EEG) during anesthesia in children are poorly described. An understanding of the EEG during anesthesia may help explain and predict the performance of EEG-derived depth of anesthesia monitors in children. This study aims to describe the association between age and some basic characteristics of the EEG during nonstandardized anesthesia in children and infants.

METHODS

Sixty-four children aged 9 days to 12 years were enrolled in this observational physiological study. Anesthesia was given at the discretion of the anesthetist. EEG was recorded from after induction to emergence using a BRM2 brain monitor ''BrainZ Instruments, Auckland, New Zealand'' in parietal and frontal montages. For comparison, 90% spectral edge frequency (SEF-90) and power were determined at three points (equilibrium during anesthesia, when the volatile agent was discontinued and at emergence), and children were divided into three age groups (0-6 months, 6-24 months and 2-12 years).

RESULTS

Fifty-seven children had artifact-free EEG data. From equilibrium to emergence the mean forehead power decreased substantially in children aged 2-12 years (3171-153 microV(2), P < 0.001) and 6-24 months (756-140 microV(2), P < 0.001) but no difference was found in infants aged 0-6 months (93-63 microV(2), P = 0.4). From equilibrium to emergence mean forehead spectral edge frequency increased in children aged 2-12 years (10.8-13.7 Hz, P = 0.01) but no change was found in children aged 6-24 months (12.7-12.7 Hz, P = 0.9) or 0-6 months (9.45-7.26 Hz, P = 0.08). Throughout emergence, infants demonstrated a discontinuous EEG pattern with intermittent bursts separated with low amplitude.

CONCLUSIONS

During anesthesia, the EEG in infants is fundamentally different from the EEG in older children. This study supports the need for specific infant-derived algorithms if EEG-derived anesthesia depth monitors are to be used in infants.

摘要

背景

儿童麻醉期间脑电图（EEG）的特征描述较少。了解麻醉期间的脑电图可能有助于解释和预测儿童中基于脑电图的麻醉深度监测仪的性能。本研究旨在描述年龄与儿童和婴儿非标准化麻醉期间脑电图的一些基本特征之间的关联。

方法

64名年龄在9天至12岁的儿童参加了这项观察性生理学研究。麻醉由麻醉师酌情给予。使用BRM2脑监测仪（“BrainZ Instruments，奥克兰，新西兰”）在顶叶和额叶导联从诱导后至苏醒期间记录脑电图。为了进行比较，在三个时间点（麻醉期间平衡期、停用挥发性麻醉剂时和苏醒时）测定90%频谱边缘频率（SEF-90）和功率，并将儿童分为三个年龄组（0-6个月、6-24个月和2-12岁）。

结果

57名儿童有脑电图无伪迹数据。从平衡期到苏醒期，2-12岁儿童（3171-153微伏²，P<0.001）和6-24个月儿童（756-140微伏²，P<0.001）的前额平均功率大幅下降，但0-6个月婴儿无差异（93-63微伏²，P=0.4）。从平衡期到苏醒期，2-12岁儿童的前额平均频谱边缘频率增加（10.8-13.7赫兹，P=0.01），但6-24个月儿童（12.7-12.7赫兹，P=0.9）或0-6个月儿童（9.45-7.26赫兹，P=0.08）无变化。在整个苏醒过程中，婴儿表现出不连续的脑电图模式，间歇性爆发与低振幅相间。