Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
Department of Anaesthesia and Intensive Care, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden.
J Int Med Res. 2022 Aug;50(8):3000605221118682. doi: 10.1177/03000605221118682.
Previous studies have attempted to determine the depth of anaesthesia with different anaesthetic agents using electroencephalogram (EEG) measurements with variable success. Measuring depth of anaesthesia is confounded by the complexity of the EEG and the fact that different agents create different pattens. A narrative review was undertaken to examine the available research evidence on the effect and reliability of spectral edge frequency (SEF) for assessing the depth of anaesthesia in adult patients under general anaesthesia. A systematic search of the PubMed®, Scopus®, CINAHL and Cochrane databases identified six randomized controlled trials and five observational studies. The findings of these studies suggest that SEF varies according to the anaesthetic drugs used. Remifentanil and age are two factors that can affect SEF, while other opioids and benzodiazepine (administered separately) seem to have no effect. No patients experienced intraoperative awareness. However, this does not indicate that SEF can provide full protection against it and the number of articles in which intraoperative awareness was studied was too small to afford any certainty. None of the studies demonstrated a reliable SEF interval associated with adequate general anaesthesia. SEF must be adapted to the anaesthetic drug used, the patient's age and state while under general anaesthesia.
先前的研究试图通过脑电图 (EEG) 测量来确定不同麻醉剂的麻醉深度，但取得的效果不一。测量麻醉深度的问题在于 EEG 的复杂性以及不同药物会产生不同模式这一事实。我们进行了一项叙述性综述，以检查关于在全身麻醉下评估成年患者麻醉深度的频谱边缘频率 (SEF) 的可用研究证据的效果和可靠性。通过对 PubMed®、Scopus®、CINAHL 和 Cochrane 数据库进行系统搜索，确定了六项随机对照试验和五项观察性研究。这些研究的结果表明，SEF 会根据使用的麻醉药物而有所不同。瑞芬太尼和年龄是两个可以影响 SEF 的因素，而其他阿片类药物和苯二氮䓬类药物（单独给药）似乎没有影响。没有患者在手术过程中出现意识清醒的情况。然而，这并不表示 SEF 可以提供充分的保护，而且研究术中意识清醒的文章数量太少，无法提供任何确定性。没有一项研究显示出与充分的全身麻醉相关的可靠 SEF 间隔。SEF 必须根据使用的麻醉药物、患者的年龄和全身麻醉状态进行调整。
