不同麻醉深度下中枢神经系统的功能状态(数量化脑电图和麻醉深度的关系)

目的：探讨数量化脑电图与七氟醚麻醉深度的关系。方法：６２例腹部手术病人，常规麻醉诱导、气管内插管。机械通气，潘库溴铵或阿曲库铵维持肌松。手术探查毕，调整每个病人的七氟醚呼气末浓度依次达２％→１．５％→１％，每种浓度维持至少１５分钟，记录３分钟数量化ＥＥＧ及ＭＡＰ、ＨＲ变化。结果：随七氟醚呼气末浓度降低，原始脑电波逐渐由低频高振幅波转变为高频低振幅波；ＳＥＦ和ＭＦ趋势曲线明显右移；ＳＥＦ、ＭＦ、ＢＩＳ、δＲ明显差异（Ｐ＜０．０１）。血流动力学的变化仅在七氟醚呼气末浓度１％与２％时有明显差异（Ｐ＜０．０１）。结论：数量化脑电图能监测不同七氟醚麻醉深度时大脑皮层电活动变化，而ＭＡＰ和ＨＲ只能区别极深和极浅的麻醉状态。

Brain electrical activity changes during sevoflurane/nitrous oxide anesthesia in humans

Objective:Using quantitative EEG parameters to assess depth of anesthesia during sevoflurane/nitrous oxide.Method:62 healthy,consenting adults undergoing abdominal surgical procedure,were studied at three levels of end tidal sevoflurane concentration(2%,1.5%,1%).Each of the concentration levels was maintained for at least 15 min,then EEG,MAP and HR were recorded for 3 min.Ventilation was controlled to maintain normocarbia(P ET CO 2 4 5kPa).Result:EEG variables(SEF,BIS,MF)decreased dramatically with increasing anesthetic levels(P<0.01).No significant changes in MAP and HR were observed when the end tidal concentration was changed from 2% to 1.5% or 1.5% to 1% ,but significant decreases in MAP and HR were found when the end tidal sevoflurane concentration changed from 2% to 1%(P<0.01).Conclusion:EEG parameters for assessing levels of anesthesia with sevoflurane/nitrous oxide are more sensitive to reflect the depth of anesthesia than haemodynamic variables.