Watcha M F, White P F
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110.
Anesthesiology. 1989 Nov;71(5):664-8. doi: 10.1097/00000542-198911000-00007.
The clinical usefulness of monitoring the frequency of spontaneous lower esophageal contractions (SLEC) to assess the depth of anesthesia was evaluated in 38 children. The hypothesis that SLEC can predict movement in response to skin incision during nitrous oxide and halothane anesthesia was tested. Although movement in response to skin incision was correlated with an increase in heart rate, blood pressure, and an increased SLEC frequency, there was no correlation between the SLEC prior to skin incision and movement in response to this stimulus. Moreover, cardiovascular responses preceded the detection of SLEC changes. The relationship between changes in SLEC activity and times to awakening during emergence from anesthesia was also examined. During emergence from anesthesia there was an increase in SLEC, but the time to awakening could not be predicted from the SLEC. Cardiovascular changes again preceded SLEC changes during emergence. Monitoring of the lower esophageal contractility rate would appear to be of limited usefulness in evaluating the depth of anesthesia in unparalyzed children during nitrous oxide and halothane anesthesia.
在38名儿童中评估了监测自发性食管下收缩（SLEC）频率以评估麻醉深度的临床实用性。对SLEC能否预测一氧化二氮和氟烷麻醉期间对皮肤切口的反应性运动这一假设进行了测试。尽管对皮肤切口的反应性运动与心率、血压增加以及SLEC频率增加相关，但皮肤切口前的SLEC与对该刺激的反应性运动之间并无关联。此外，心血管反应先于SLEC变化被检测到。还研究了SLEC活动变化与麻醉苏醒期间苏醒时间的关系。在麻醉苏醒期间SLEC增加，但无法根据SLEC预测苏醒时间。苏醒期间心血管变化同样先于SLEC变化。在一氧化二氮和氟烷麻醉期间，监测食管下收缩率在评估未麻痹儿童的麻醉深度方面似乎作用有限。
