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[全身麻醉期间基于脑电图的脑监测中的定量脑电图]

[The quantitative EEG in electroencephalogram-based brain monitoring during general anesthesia].

作者信息

Kaiser H A, Knapp J, Sleigh J, Avidan M S, Stüber F, Hight D

机构信息

Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Universitätsspital Bern, Freiburgstr., 3010, Bern, Schweiz.

Department of Anaesthesia, Waikato Clinical School, University of Auckland, Hamilton, Neuseeland.

出版信息

Anaesthesist. 2021 Jun;70(6):531-547. doi: 10.1007/s00101-021-00960-5. Epub 2021 May 10.

Abstract

The electroencephalogram (EEG) is increasingly being used in the clinical routine of anesthesia in German-speaking countries. In over 90% of patients the frontal EEG changes somewhat predictably in response to administration of the normally used anesthetic agents (propofol and volatile gasses). An adequate depth of anesthesia and appropriate concentrations of anesthetics in the brain generate mostly frontal oscillations between 8 and 12 Hz as well as slow delta waves between 0.5 and 4 Hz. The frontal EEG channel is well-suited for avoidance of insufficient depth of anesthesia and excessive administration of anesthetics. This article explains the clinical interpretation of the most important EEG patterns and the biophysical background. Also discussed are important limitations and pitfalls for the clinical routine, which the anesthetist should know in order to utilize the EEG as an admittedly incomplete but clinically extremely important parameter for the level of consciousness.

摘要

在德语国家,脑电图(EEG)在麻醉临床常规中越来越多地被使用。在超过90%的患者中,额叶脑电图变化在一定程度上可预测地响应常用麻醉剂(丙泊酚和挥发性气体)的给药。足够的麻醉深度和大脑中适当浓度的麻醉剂主要产生8至12赫兹之间的额叶振荡以及0.5至4赫兹之间的慢波δ波。额叶脑电图通道非常适合避免麻醉深度不足和麻醉剂过量给药。本文解释了最重要的脑电图模式的临床解读及其生物物理背景。还讨论了临床常规中的重要局限性和陷阱,麻醉医生应该了解这些,以便将脑电图作为一个公认不完整但临床上极其重要的意识水平参数加以利用。

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