Schwilden H
Anasth Intensivther Notfallmed. 1985 Dec;20(6):307-15.
The quantitative aspects of dosing of volatile anaesthetics to establish and maintain constant alveolar concentrations are in general only discussed in the framework of closed circuit anaesthesia. A systematic approach to determine the appropriate dosage for arbitrary flows on the basis of pharmacokinetic models and to adjust the parameters of the model to the individual patient is described. A pharmacodynamic model of the volatile agents isoflurane, enflurane and halothane based on the electroencephalogram is worked out and added to the kinetic model. The median of the EEG power spectrum serves as a monoparametric correlate of depth of anaesthesia. A system theoretic consideration of the coupled subsystems, anaesthesia machine and patient, enables the establishment of interactive dosing strategies, thus offering the possibility of adapting dosage to the different painful phases of surgery. The implications of these dosing strategies for feed back control of anaesthesia by electroencephalographic means are discussed.
挥发性麻醉剂给药的定量方面，以建立和维持恒定的肺泡浓度，通常仅在闭环麻醉的框架内进行讨论。本文描述了一种基于药代动力学模型确定任意流量下合适剂量，并将模型参数调整至个体患者的系统方法。基于脑电图建立了挥发性麻醉剂异氟烷、恩氟烷和氟烷的药效学模型，并将其添加到动力学模型中。脑电图功率谱的中位数作为麻醉深度的单参数关联指标。对麻醉机和患者这两个耦合子系统进行系统理论考量，能够制定交互式给药策略，从而为根据手术不同疼痛阶段调整剂量提供了可能。文中还讨论了这些给药策略对通过脑电图手段进行麻醉反馈控制的影响。
