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单次静注氯胺酮qEEG的 波特点分析 |
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梁韶军 岳云 隋大凯 杨永慧
摘要 目的：通过对单次静注氯胺酮（Ket）的定量脑电图（qEEG）分析来进一步加深认识此药的麻醉性能，探求可以反映其麻醉深度的指标。方法：9例ASAⅠ～Ⅱ级，年龄22～27岁，Ket 4mg／kg单次静脉注射，分术前、ket静注后第5分钟及第20分钟三个时段作qEEG监测并采集各项参数值，行前后自身对照。结果：①REL：可见术前各导联均以α波为主，θ波成份最小。但给药后5分钟却完全以θ波为主，至第20分钟仍以θ波为主。②δ比率：术前处于低比率状态，给药5分钟后比率显著上升（P＜0.01），第20分钟时比率回落，其中F7、F8导联已与术前无显著差异。③θ比率：术前低，给药第5分钟时比率骤升，20分钟时回落不显著，维持时间长于δ比率。而用反θ比率则更能清楚地显示这一特征，术前的高比率在给药第5分钟时骤然崩解，第20分钟时略有上升趋势。结论：EEG持久高功率的θ波活动是单次静注Ket 4mg／kg麻醉的特征表现；δ比率的变化趋势能反映患者的临床初醒状态，而“θ比率”与“反θ比率”较δ比率能更实际地反映大脑意识变化情况。
关键词 氯胺酮 EEG
Analysis of The θ Power of qEEG Caused by a Bolus Intravenous Ketamine
Liang Shaojun，Yue Yun，Sui Dakai，et al
Tangdu Hospital，Fourth Military Medical University 710038
Abstract Objective：To investigate whether qEEG can be a credible index to judge the depth of anaesthesia of ketamine（Ket）．Methods：qEEG was recorded before and at 5min and 20min after iv injection of 4mg／kg of Ket in 9 adult female patients．Results：①REL：The α power was predominant on all leads before injection of Ket and the θ power was minimal，but at 5min after injection the θ power became completely dominant and lasted for more than 20min．②δ ratio：Before injectin of Ket δ ratio was little and at 5min after injection it was increased significantly （P＜0.01）．It began to decrease in 20min of injection，and even was the same as that before injection in F7、F8 leads．③θ ratio：θ ratio was low before injection and rose abruptly at 5min after injection and lasted at least for 20min．At the same time inverse θ ratio decreased abruptly．Conclusions：Durable high θ power is a character of a bolus Ket anaesthesia．The change of δ ratio can reflect the status of initial awakening from ket．θ ratio and reverse θ ratio reflect more accurately the status of anaesthesia of Ket than &de[1] [2] [3] 下一页
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