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定量脑电图监测全麻状态下意识的变化 |
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孙永海 岳云 王凤学 刘晓江 王朝仁 唐胜平 朱滢
摘要 目的：判断定量脑电图在全麻下监测意识的价值。方法：无神经系统损伤的健康志愿者，按0、0.2、0.3、0.4MAC递增呼末异氟醚浓度，观察qEEG及指令反应变化，通过事后调查麻醉中的外显及内隐记忆。结果：按全麻下意识水平的1～4个阶段，第2与第1阶段相比，qEEGF7、F8、A1导联θ波相对功率明显降低（P＜0.05）；第3与第2阶段相比，O1、及O2导联的α波相对功率明显降低（P＜0.05），O2导联δ波功率明显升高（P＜0.05）。余qEEG参数包括SEF、MPF及δ比率均无明显变化（P＞0.05）。所有qEEG参数变异较大，不能定出界值。结论：qEEG在判断按意识分级的麻醉深度上只能作为一种趋势的预示，不能作为可靠的定量指标。
关键词 麻醉深度 内隐记忆 外显记忆 定量脑电图 监测
A Study of qEEG during Monitoring of Consciousness under General Anesthesia
Sun Yonghai，Yue Yun，Wang Fengxue，et al
Department of Anesthesiology，Shenyang Military Region General Hospital，Shenyang 110015
Abstract Objective：To evaluate the value of qEEG during monitoring of consciousness under general anesthesia．Methods：The end-expiratory concentration of isoflurane was increased gradually from 0.2MAC by step of 0.1MAC in each of ten healthy volunteers until no response to command．The changes of qEEG and the response to command were observed．The explicit and implicit memories about introexperiment events were investigated at one hour of stopping inhalation of isoflurane．Results：Compared with the first stage of the cognitive function，the θ power of qEEG about the second stage decreased significantly in F7，F8，A1 recording electrodes（P＜0.05）；compared with the second stage，the α power of qEEG about the third stage decreased remarkably in O1 and O2 recording electrodes，the δ power increased significantly in O2 recording electrodes （P＜0.05）．The critical value of all descriptors of qEEG could not be defined because of the considerable variations．Conclusion：qEEG is not the credible index in determining the depth of anesthesia and can only be used for predictiong the tendency．
Key words Depth of anesthesia Implicit memory Explicit memory Quantitative electroencephalogram Monitoring
按意识水平区分全麻深度［1］可避免术中知晓带来的不良影响，定量脑电图（qEEG）能否作为判断全麻深度的可靠指标仍存在争议［2，3］。本研究旨在通过观察低浓度异[1] [2] 下一页
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