在儿科手术期间,通过患者状态指数监测麻醉深度
Zaccaria Ricci1,2, Chiara Robino2, Paolo Rufini2
1Department of Health Sciences, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.
Paediatric anaesthesia
|June 19, 2023
概括
在儿童中,经过处理的脑电图 (EEG) 监测显示患者状态指数 (PSI) 值在麻醉深度的建议范围内,但频繁出现爆发抑制事件. 年龄较小的儿童 (<2岁) 呈现出更高的PSI水平.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 儿科医学 儿科医学
背景情况:
- 在儿科患者中监测麻醉深度是复杂的,通常依赖于间接方法.
- 经过处理的脑电图 (EEG) 为客观麻醉深度评估提供了一个潜在的工具.
- 患者状态指数 (PSI) 是从经过处理的EEG中获得的指标.
研究的目的:
- 为了确定中位患者状态指数 (PSI) 和光谱边缘频率95% (SEF95%) 在接受全身麻醉的儿童中的值.
- 评估PSI,SEF95%和间接麻醉监测参数之间的关系.
- 评估麻醉类型,年龄和爆发抑制对PSI的影响.
主要方法:
- 一项前性观察性研究,涉及111名年龄在1-18岁的儿童接受手术>60分钟.
- 使用SedLine显示器和儿科传感器进行持续的PSI和SEF95%记录.
- 从麻醉诱导到病房出院记录了PSI水平.
主要成果:
- 诱导时的PSI中位数为25,维持时间为26-28,输出48和排出69.
- 中位数SEF95%值在维护期间为9-12Hz,在输出时为17-18Hz.
- 爆发抑制发生在19%的患者中;PSI在麻醉类型之间没有显著差异.
- 2岁以下的儿童与年长的儿童相比,PSI水平显著更高.
结论:
- 儿童未经处理的EEG导向麻醉导致PSI值处于推失去意识范围的下端.
- 观察到频繁的爆发抑制情节,表明可能比预期更深的麻醉.
- 较小的儿童 (<2岁) 始终显示出更高的PSI水平,这表明对解释的年龄特定考虑.
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