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一项比较芬太尼和氯胺酮在接受微创手术的成年患者脑电波模式的研究。

A study comparing brain wave patterns of fentanyl and ketamine in adult patients undergoing minimally invasive surgery.

机构信息

Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, China.

出版信息

Medicine (Baltimore). 2024 Sep 20;103(38):e38049. doi: 10.1097/MD.0000000000038049.

Abstract

This study aimed to investigate and compare the neurophysiological impacts of two widely used anesthetic agents, Fentanyl and Ketamine, on EEG power spectra during different stages of anesthesia in adult patients undergoing minimally invasive surgery. EEG data were collected from patients undergoing anesthesia with either Fentanyl or Ketamine. The data were analyzed for relative power spectrum and fast-to-slow wave power ratios, alongside Spectral Edge Frequency 95% (SEF95), at 3 key stages: pre-anesthesia, during stable anesthesia, and post-anesthesia. EEG Relative Power Spectrum: Initially, both groups exhibited similar EEG spectral profiles, establishing a uniform baseline (P > .05). Upon anesthesia induction, the Fentanyl group showed a substantial increase in delta band power (P < .05), suggesting deeper anesthesia, while the Ketamine group maintained higher alpha and beta band activity (P < .05), indicative of a lighter sedative effect. Fast and Slow Wave Power Ratios: The Fentanyl group exhibited a marked reduction in the fast-to-slow wave power ratio during anesthesia (P < .05), persisting post-anesthesia (P < .05) and indicating a lingering effect on brain activity. Conversely, the Ketamine group demonstrated a more stable ratio (P > .05), conducive to settings requiring rapid cognitive recovery. Spectral Edge Frequency 95% (SEF95): Analysis showed a significant decrease in SEF95 values for the Fentanyl group during anesthesia (P < .05), reflecting a shift towards lower frequency power. The Ketamine group experienced a less pronounced decrease (P > .05), maintaining a higher SEF95 value that suggested a lighter level of sedation. The study highlighted the distinct impacts of Fentanyl and Ketamine on EEG power spectra, with Fentanyl inducing deeper anesthesia as evidenced by shifts towards lower frequency activity and a significant decrease in SEF95 values. In contrast, Ketamine's preservation of higher frequency activity and more stable SEF95 values suggests a lighter, more dissociative anesthetic state. These findings emphasize the importance of EEG monitoring in anesthesia for tailoring anesthetic protocols to individual patient needs and optimizing postoperative outcomes.

摘要

本研究旨在探讨和比较两种广泛使用的麻醉剂——芬太尼和氯胺酮在成人微创手术患者麻醉不同阶段对脑电图(EEG)频谱的神经生理学影响。从接受芬太尼或氯胺酮麻醉的患者中收集 EEG 数据。对相对功率谱和快-慢波功率比以及频谱边缘频率 95%(SEF95)进行分析,在 3 个关键阶段:麻醉前、稳定麻醉期间和麻醉后。EEG 相对功率谱:最初,两组都表现出相似的 EEG 频谱特征,建立了一个统一的基线(P>.05)。在麻醉诱导时,芬太尼组的 delta 波段功率显著增加(P<.05),表明麻醉深度增加,而氯胺酮组保持较高的 alpha 和 beta 波段活动(P<.05),表明镇静作用较轻。快-慢波功率比:芬太尼组在麻醉期间快-慢波功率比明显降低(P<.05),麻醉后持续(P<.05),表明对大脑活动有挥之不去的影响。相反,氯胺酮组表现出更稳定的比值(P>.05),有利于需要快速认知恢复的设置。频谱边缘频率 95%(SEF95):分析表明,芬太尼组在麻醉期间 SEF95 值显著降低(P<.05),反映出向低频功率的转移。氯胺酮组的下降幅度较小(P>.05),保持较高的 SEF95 值,表明镇静水平较低。该研究强调了芬太尼和氯胺酮对 EEG 频谱的不同影响,芬太尼通过向低频活动转移和 SEF95 值的显著降低,诱导更深的麻醉。相比之下,氯胺酮保留了较高的高频活动和更稳定的 SEF95 值,表明其麻醉状态较轻,分离作用更强。这些发现强调了在麻醉中进行 EEG 监测的重要性,以便根据患者的个体需求调整麻醉方案并优化术后结果。

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