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麻醉与重症监护期间的脑电图监测:临床医生指南

Electroencephalogram monitoring during anesthesia and critical care: a guide for the clinician.

作者信息

Manohara Nitin, Ferrari Alessandra, Greenblatt Adam, Berardino Andrea, Peixoto Cristina, Duarte Flávia, Moyiaeri Zahra, Robba Chiara, Nascimento Fabio A, Kreuzer Matthias, Vacas Susana, Lobo Francisco A

机构信息

Division of Anesthesiology, Cleveland Clinic Abu Dhabi, Integrated Hospital Care Institute, Abu Dhabi, United Arab Emirates.

RCCS Policlinico San Martino, Genoa, Italy.

出版信息

J Clin Monit Comput. 2025 Apr;39(2):315-348. doi: 10.1007/s10877-024-01250-2. Epub 2024 Dec 20.

DOI:10.1007/s10877-024-01250-2
PMID:39704777
Abstract

Perioperative anesthetic, surgical and critical careinterventions can affect brain physiology and overall brain health. The clinical utility of electroencephalogram (EEG) monitoring in anesthesia and intensive care settings is multifaceted, offering critical insights into the level of consciousness and depth of anesthesia, facilitating the titration of anesthetic doses, and enabling the detection of ischemic events and epileptic activity. Additionally, EEG monitoring can aid in predicting perioperative neurocognitive disorders, assessing the impact of systemic insults on cerebral function, and informing neuroprognostication. This review provides a comprehensive overview of the fundamental principles of electroencephalography, including the foundations of processed and quantitative electroencephalography. It further explores the characteristic EEG signatures associated wtih anesthetic drugs, the interpretation of the EEG data during anesthesia, and the broader clinical benefits and applications of EEG monitoring in both anesthetic practice and intensive care environments.

摘要

围手术期的麻醉、外科手术及重症监护干预措施会影响大脑生理机能和整体大脑健康。脑电图(EEG)监测在麻醉和重症监护环境中的临床应用是多方面的,它能提供有关意识水平和麻醉深度的关键见解,有助于麻醉剂量的滴定,并能检测缺血性事件和癫痫活动。此外,EEG监测有助于预测围手术期神经认知障碍,评估全身性损伤对脑功能的影响,并为神经预后评估提供依据。本综述全面概述了脑电图的基本原理,包括经处理的和定量脑电图的基础。它进一步探讨了与麻醉药物相关的特征性EEG信号、麻醉期间EEG数据的解读,以及EEG监测在麻醉实践和重症监护环境中的更广泛临床益处和应用。

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本文引用的文献

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Intraoperative use of processed electroencephalogram in a quaternary center: a quality improvement audit.四级中心中处理后的脑电图的术中应用:质量改进审核。
J Clin Monit Comput. 2024 Dec;38(6):1263-1268. doi: 10.1007/s10877-024-01189-4. Epub 2024 Jun 20.
2
Berger and the Breakthrough: A Centennial Celebration of the Human Electroencephalogram.《伯杰与突破:人类脑电图的百年庆典》。
Neurodiagn J. 2024 Jun;64(2):69-74. doi: 10.1080/21646821.2024.2327268. Epub 2024 May 21.
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Postoperative Delirium and the Older Adult: Untangling the Confusion.
HeartMate 3™对脑电双频指数(Bispectral Index™)监测仪的影响:一项回顾性观察研究。
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Processed electroencephalography-guided general anesthesia and norepinephrine requirements: A randomized trial in patients having vascular surgery.处理后的脑电图引导全身麻醉和去甲肾上腺素需求:血管手术患者的随机试验。
J Clin Anesth. 2024 Aug;95:111459. doi: 10.1016/j.jclinane.2024.111459. Epub 2024 Apr 9.
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Continuity with caveats in anesthesia: state and response entropy of the EEG.麻醉中存在连续性问题:EEG 的状态和反应熵。
J Clin Monit Comput. 2024 Oct;38(5):1057-1068. doi: 10.1007/s10877-024-01130-9. Epub 2024 Apr 3.
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Acta Anaesthesiol Scand. 2024 Jul;68(6):781-787. doi: 10.1111/aas.14420. Epub 2024 Mar 29.
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