国际麻醉学与复苏杂志   2025, Issue (3): 0-0
    
基于脑电图的儿童麻醉深度监测研究进展
张玥, 宋琳琳, 王东信1()
1.北京大学第一医院
Progress of monitoring the depth of sedation based on electroencephalogram in children
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摘要:

全身麻醉药物可逆地抑制大脑皮层电活动,随着麻醉加深脑电图逐渐由高频率快波向低频率慢波过度直至出现等电位。对麻醉期间脑电图通过特定算法可分析得到不同指数,基于此研发的各种专有麻醉深度监测工具已在成人临床应用中得到验证。青春期前儿童大脑处于快速发育阶段,麻醉时呈现的脑电波形与成人存在一定差异,因此各种专有麻醉深度监测工具在儿童中的应用还存在争议。非专有的脑电参数受年龄影响较小,能够在常规监测的基础上辅助判断低龄婴幼儿的麻醉深度。本文介绍了临床中常用的麻醉深度监测工具和非专有脑电参数以及在儿童中应用的最新进展,分析了不同工具的特点和局限性,为未来儿童麻醉深度监测的发展方向提供了参考。

关键词: 麻醉;麻醉深度;监测;非专有脑电参数;小儿麻醉
Abstract:

EEG can be affected reversibly by sedative substances, consist in a progressive slowing up to the occurrence of intermittent suppression phases and finally to a continuous suppression of the EEG. Analyzing electroencephalogram during anesthesia with specific algorithms derives different index. Various proprietary devices monitoring depth of sedation have been validated in adult clinical applications. The period from birth to adolescence is marked by a particularly rapid development and fundamental changes in brain connectivity, which are reflected in the different effects of anesthetics on EEG oscillations during this period, hence the application of these proprietary anesthesia depth monitors in children is still controversial. Non-proprietary EEG parameters are less affected by age and can assist in monitoring the depth of anesthesia in young children on the basis of routine monitoring. This article introduces several common proprietary anesthesia depth monitoring tools and non-proprietary EEG parameters and their characteristics and limitations, with the latest progress in their application in children, providing reference for the future development of anesthesia depth monitoring.

Key words: Anesthesia; Depth of sedation; Monitoring; Non-proprietary EEG parameters; Pediatric anesthesia