Edwards N D, Mason D G, Ross J J
University Department of Anaesthetics, Northern General Hospital, Sheffield, UK.
Anaesthesia. 1998 Feb;53(2):136-9. doi: 10.1046/j.1365-2044.1998.00296.x.
We have assessed the practicality and performance of the Vital Signs Paragraph neuromuscular blockade monitor as part of a 'self-learning' fuzzy logic control feedback system used to administer atracurium to a required depth of neuromuscular blockade. Fifteen patients undergoing surgery expected to last longer than 90 min entered the study. A Vital Signs Paragraph was used to measure the degree of neuromuscular blockade and control it such that the first twitch of the train-of-four was kept at 10% of its baseline value. The controller instructed a Graseby Medical 3400 infusion pump to administer an atracurium infusion to maintain this level of blockade. Five patients (33%) were withdrawn from the study due to inadequate piezo-electric sensor function. In the remaining 10 patients, the system achieved stable control of neuromuscular blockade with a mean (range) error for the first twitch of the train-of-four of -0.45 (-1.06 to 0.13)%. The mean atracurium infusion rate ranged from 0.13 to 0.67 mg.kg-1.h-1. These results compare reasonably well with previous results using the Datex Relaxograph, whilst the system itself was portable and easy to use. However, the reliability of the system was limited due to variability in the sensitivity of piezoelectric sensors.
我们评估了生命体征段落神经肌肉阻滞监测仪的实用性和性能，该监测仪是用于将阿曲库铵给药至所需神经肌肉阻滞深度的“自学习”模糊逻辑控制反馈系统的一部分。15名预计手术持续时间超过90分钟的患者进入了该研究。使用生命体征段落来测量神经肌肉阻滞程度并进行控制，以使四个成串刺激中的第一个颤搐保持在其基线值的10%。控制器指示Graseby Medical 3400输液泵给予阿曲库铵输注以维持该阻滞水平。5名患者（33%）因压电传感器功能不足而退出研究。在其余10名患者中，该系统实现了对神经肌肉阻滞的稳定控制，四个成串刺激中第一个颤搐的平均（范围）误差为-0.45（-1.06至0.13）%。阿曲库铵的平均输注速率范围为0.13至0.67mg·kg⁻¹·h⁻¹。这些结果与先前使用Datex Relaxograph的结果相当，同时该系统本身便于携带且易于使用。然而，由于压电传感器灵敏度的变异性，该系统的可靠性受到限制。
