bispectralindexmonitoring(bis)-anaesthesianews：腦電雙頻指數(shù)bis-麻醉新聞(編輯修改稿)
2025-02-14 23:54 本頁(yè)面
【文章內(nèi)容簡(jiǎn)介】 ory ? Tunstall: 9/12 pts showed arm movements during procedure (IFT) 4/9 appropriately – none recalled ? Russell: 61% were able to move arm to mand (given thio/dtc/nitous/oxygen) – none recalled ? Changes in BP, pulse, sweating amp。 tears were shown to be poor indicators of awareness Awareness without explicit memory ? 80% of patients induced with Midazolam amp。 fentanyl and 70% induced with Midazolam amp。 Alfentanil showed hand movement ? While breathing low doses of Isoflurane (% ET) subjects were able to prehend and respond to words Subconscious awareness with implicit memory ? Increasing anaesthetic concentration leads to reduction in working memory, then loss of conciousness and explicit memory, whereas implicit memory of intraop events may remain!! ? Indirect tests of memory must be used to demonstrate evidence of implicit memory amp。 learning Subconscious awareness with implicit memory ? Category generation, free association, stem pletion tests are used ? Conflicting study results ? Positive suggestions intraop: stop smoking, faster recovery Preventing Awareness ? ‘High’ risk patients / situations ? Detecting / Monitoring anaesthetic depth intraop ? Drugs ? Avoiding certain anaesthetic techniques ? Patient information Detection of Awareness ? Clinical signs ? Clinical experience ? IFT ? Lower oesophageal contractility ? Frontalis EMG ? Respiratory sinus arrhythmia ? EEG – Raw EEG – Processed EEG ? BiS ? AEP PRST Score Isolated Forearm Technique (IFT) ? First used by Tunstall ? Isolate forearm with BP cuff before giving NMB ? Patients asked to squeeze hand for ‘Yes’ ? Limitations: time。 surgery on the hand ? Even when patients responded, rarely did they have any memory of this after the operation Monitoring Awareness… ?
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