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[神经监测与意识]

[Neuromonitoring and awareness].

作者信息

Posch Matthias J, Baars Jan H

机构信息

Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Campus Charité Mitte und Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Germany.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 Jan;48(1):40-5; quiz 46. doi: 10.1055/s-0032-1333080. Epub 2013 Jan 30.

Abstract

Awareness is a rare but in some cases severe complication of general anesthesia. In clinical practice vegetative signs such as sweating, lacrimation, tachycardia and hypertension are used to assess the anesthetic depth. Awareness however may also occur without any of these signs. Different systems based on the electroencephalogram (EEG) have been developed to monitor hypnosis. Some studies have shown that the use of EEG based monitor systems can reduce the incidence of awareness in patients of high risk. A similar reduction of the incidence was reached in studies using protocols based on concentrations of volatile anesthetics. Other systems to monitor anesthetic depth have been developed, but their influence on awareness has not yet been investigated sufficiently. Further studies are needed to clarify their impact concerning the incidence of awareness.

摘要

术中知晓是全身麻醉中一种罕见但在某些情况下较为严重的并发症。在临床实践中,出汗、流泪、心动过速和高血压等植物神经体征被用于评估麻醉深度。然而,术中知晓也可能在没有这些体征的情况下发生。基于脑电图(EEG)的不同系统已被开发用于监测催眠状态。一些研究表明,使用基于EEG的监测系统可降低高危患者术中知晓的发生率。在使用基于挥发性麻醉剂浓度的方案的研究中,知晓发生率也有类似程度的降低。其他监测麻醉深度的系统也已被开发出来,但它们对术中知晓的影响尚未得到充分研究。需要进一步研究以阐明它们对术中知晓发生率的影响。

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