Lersch F, Zingg T J G, Knapp J, Stüber F, Hight D, Kaiser H A
Universitätsklinik für Anästhesiologie und Schmerzmedizin, Inselspital, Universitätsspital Bern, Universität Bern, Freiburgstrasse, 3010, Bern, Schweiz.
Zentrum für Anästhesiologie und Intensivmedizin, Hirslanden Klinik Aarau, Hirslanden AG, Schänisweg, 5001, Aarau, Schweiz.
Anaesthesiologie. 2023 Sep;72(9):662-676. doi: 10.1007/s00101-023-01313-0. Epub 2023 Aug 8.
Electroencephalogram (EEG)-guided anesthesia is indispensable in modern operating rooms and has become established as the standard form of monitoring. Many anesthesiologists rely on processed EEG indices in the hope of averting anesthesia-related complications, such as intraoperative awareness, postoperative delirium and other cognitive complications in their patients. This educational review aims to provide information on the five most prevalent monitors used to guide depth of sedation during general anesthesia. This article elucidates the principles underpinning the application of these monitors where known, which are generally based on power in various EEG frequency bands and on the burst suppression pattern. Convinced that EEG-guided anesthesia has the potential of benefitting many surgical patients, it is felt that many basic principles and shortcomings of processed EEG indices need to be better understood in the clinical practice. After discussing the different monitors and clinically relevant data from the literature, the article gives a short practical guidance on how to critically interpret processed EEG information and troubleshooting of confounded indices in the context of clinical situations.
脑电图(EEG)引导下的麻醉在现代手术室中不可或缺,并已成为既定的监测标准形式。许多麻醉医生依赖经过处理的脑电图指标,希望避免患者出现与麻醉相关的并发症,如术中知晓、术后谵妄及其他认知并发症。本教育综述旨在提供有关全身麻醉期间用于指导镇静深度的五种最常用监测仪的信息。本文阐明了这些监测仪已知的应用原理,这些原理通常基于不同脑电图频段的功率和爆发抑制模式。相信脑电图引导下的麻醉有可能使许多手术患者受益,认为在临床实践中需要更好地理解经过处理的脑电图指标的许多基本原理和缺点。在讨论了不同的监测仪和文献中的临床相关数据后,本文就如何批判性地解读经过处理的脑电图信息以及在临床情况下对混淆指标进行故障排除给出了简短的实用指导。