van Gils Mark, Korhonen Ilkka, Yli-Hankala Arvi
VTT Information Technology, Tampere, Finland.
Department of Anaesthesiology. Medical School, University of Tampere, and Department of Anaesthesia, Tampere University Hospital, Tampere, Finland.
Crit Rev Biomed Eng. 2017;45(1-6):187-218. doi: 10.1615/CritRevBiomedEng.v45.i1-6.100.
Assessing adequacy of anesthesia requires evaluation of its components: hypnosis, analgesia, and neuromuscular transmission. In order to do this, many methods have been developed that process signals representing different modalities. Assessment of hypnosis requires cortical measures of the central nervous system (CNS); methods that assess analgesia concentrate on subcortical and spinal levels of the CNS; and neuromuscular transmission is a peripheral phenomenon. This article presents an overview of the current state of methods available for measuring each of these components. We conclude that, whereas important gains have been made in the area of assessment of hypnosis, mainly owing to the advancement of methods using EEG and auditory evoked potentials, and whereas neuromuscular transmission can be objectively monitored using motor nerve stimulation, assessment of analgesia still contains many challenges.
催眠、镇痛和神经肌肉传递。为了做到这一点，已经开发了许多处理代表不同模式信号的方法。催眠评估需要对中枢神经系统（CNS）进行皮层测量；评估镇痛的方法集中在中枢神经系统的皮层下和脊髓水平；而神经肌肉传递是一种外周现象。本文概述了目前可用于测量这些组成部分的方法的现状。我们得出的结论是，尽管在催眠评估领域取得了重要进展，这主要归功于使用脑电图和听觉诱发电位的方法的进步，并且尽管可以使用运动神经刺激客观地监测神经肌肉传递，但镇痛评估仍然存在许多挑战。
