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计算机辅助控制麻醉深度。

Computer assistance in the control of depth of anaesthesia.

作者信息

Chilcoat R T, Lunn J N, Mapleson W W

出版信息

Br J Anaesth. 1984 Dec;56(12):1417-32. doi: 10.1093/bja/56.12.1417.

DOI:10.1093/bja/56.12.1417
PMID:6437423
Abstract

A control system was used to bring the tension of anaesthetic in the brain to any value specified (in MAC units) by the anaesthetist and then maintain it constant until a new value was specified. The control was applied to a volatile agent but allowance was automatically made for the anaesthetic effect of any nitrous oxide concomitantly administered by the anaesthetist. The inspired concentration required to achieve the desired brain tension was calculated from a model of the patient and set automatically on the vaporizer. The quantification of the model was matched to the patient on the basis mainly of body mass and periodic non-invasive measurements of alveolar ventilation and cardiac output. In order to adapt the model to the patient an arterial blood sample was taken every 30 min to obtain the arterial tension of halothane for use as feedback. The system has been tested on eight Alsatian dogs. After omitting results affected by avoidable errors, the SD of the measured-to-computed arterial tension ratio was less than 10%.

摘要

使用一个控制系统将大脑中麻醉剂的张力调节至麻醉师指定的任何值(以MAC单位计),然后保持恒定,直到指定新的值。该控制应用于挥发性麻醉剂,但会自动考虑麻醉师同时给予的任何一氧化二氮的麻醉效果。根据患者模型计算达到所需大脑张力所需的吸入浓度,并在蒸发器上自动设置。该模型的量化主要基于体重以及肺泡通气和心输出量的定期无创测量来与患者匹配。为了使模型适应患者,每30分钟采集一次动脉血样以获取氟烷的动脉张力用作反馈。该系统已在8只阿尔萨斯犬身上进行了测试。在剔除受可避免误差影响的结果后,实测与计算的动脉张力比值的标准差小于10%。

相似文献

1
Computer assistance in the control of depth of anaesthesia.计算机辅助控制麻醉深度。
Br J Anaesth. 1984 Dec;56(12):1417-32. doi: 10.1093/bja/56.12.1417.
2
Controlled anaesthesia: a clinical evaluation of an approach using patient characteristics identified during uptake.可控麻醉:对一种利用吸入过程中识别出的患者特征的方法的临床评估。
Br J Anaesth. 1983 Nov;55(11):1065-75. doi: 10.1093/bja/55.11.1065.
3
Blood-gas tension measurement in anaesthesia by bubble equilibration and mass spectrometry.麻醉中通过气泡平衡和质谱法测量血气张力
Br J Anaesth. 1980 Nov;52(11):1061-70. doi: 10.1093/bja/52.11.1061.
4
Control of end-tidal halothane concentration. Part A: Anaesthesia breathing system and feedback control of gas delivery.
Br J Anaesth. 1986 May;58(5):555-62. doi: 10.1093/bja/58.5.555.
5
Feedback control of enflurane delivery in dogs--inspired compared to end-tidal control.犬体内安氟醚输送的反馈控制——与呼气末控制相比的吸气相控制
Anesth Analg. 1983 Sep;62(9):836-40.
6
Controller anaesthesia: an approach using patient characteristics identified during uptake.
Br J Anaesth. 1981 Oct;53(10):1019-26. doi: 10.1093/bja/53.10.1019.
7
Circulatory effects of halothane and halothane-nitrous oxide anesthesia in the dog: spontaneous ventilation.
Am J Vet Res. 1975 Feb;36(2):197-200.
8
[Effects of hypocapnia and hypercapnia on distribution of cardiac output in dogs under nitrous oxide-halothane anesthesia (author's transl)].
Kokyu To Junkan. 1976 Sep 15;24(9):805-13.
9
Circulatory effects of halothane and halothane-nitrous oxide anesthesia in the dog: controlled ventilation.
Am J Vet Res. 1974 Oct;35(10):1289-93.
10
Electronic digital computer control of ventilation and anaesthesia.
Anaesth Intensive Care. 1973 Aug;1(5):382-92. doi: 10.1177/0310057X7300100504.

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1
Fuzzy-logic control of blood pressure through enflurane anesthesia.
J Clin Monit. 1994 Mar;10(2):110-7. doi: 10.1007/BF02886823.
2
Feedback control methods for drug dosage optimisation. Concepts, classification and clinical application.药物剂量优化的反馈控制方法。概念、分类及临床应用。
Clin Pharmacokinet. 1985 Nov-Dec;10(6):457-76. doi: 10.2165/00003088-198510060-00001.