Washington University School of Medicine, Saint Louis, Missouri, USA.
Anaesthesia. 2014 Aug;69(8):899-910. doi: 10.1111/anae.12711. Epub 2014 Jun 6.
Although the brain is the target organ of general anaesthesia, the utility of intra-operative brain monitoring remains controversial. Ideally, the incorporation of brain monitoring into routine practice would promote the maintenance of an optimal depth of anaesthesia, with an ultimate goal of avoiding the negative outcomes that have been associated with inadequate or excessive anaesthesia. A variety of processed electroencephalogram devices exist, of which the bispectral index is the most widely used, particularly in the research setting. Whether such devices prove to be useful will depend not only on their ability to influence anaesthetic management but also on whether the changes they promote can actually affect clinically important outcomes. This review highlights the evidence for the role of bispectral index monitoring, in particular, in guiding anaesthetic management and influencing clinical outcomes, specifically intra-operative awareness, measures of early recovery, mortality and neurocognitive outcomes.
虽然大脑是全身麻醉的靶器官，但术中脑监测的实用性仍存在争议。理想情况下，将脑监测纳入常规实践将有助于维持最佳的麻醉深度，最终目标是避免与麻醉不足或过量相关的不良后果。存在各种处理后的脑电图设备，其中双频谱指数是最广泛使用的，特别是在研究环境中。这些设备是否有用不仅取决于它们影响麻醉管理的能力，还取决于它们所促进的变化是否确实能够影响临床重要的结果。本综述强调了双谱指数监测的作用证据，特别是在指导麻醉管理和影响临床结果方面，具体包括术中意识、早期恢复测量、死亡率和神经认知结果。
