首页> 外文期刊>The Internet Journal of Anesthesiology >Clinical Analysis of EEG Parameters In Prediction Of The Depth Of Anesthesia In Different Stages: A Comparative Study
【24h】

Clinical Analysis of EEG Parameters In Prediction Of The Depth Of Anesthesia In Different Stages: A Comparative Study

机译:脑电参数在不同阶段麻醉深度预测中的临床分析:比较研究

获取原文
           

摘要

Introduction: Evaluation of the depth of anesthesia is especially important in good and useful handling of the patient. Clinical assessment of EEG in the operating room is one of the major difficulties in this field.This study tries to find the most valuable EEG parameters in prediction the depth of anesthesia in different stages. Material and methods: EEG data of 30 patients with same anesthesia protocol (total intravenous anesthesia) were recorded in all anesthetic stages at the SHOHADA-E- TAJRISH hospital.Quantitative EEG characteristics were classified into 4 categories: time, frequency, bispectral and entropy based characteristics.Their sensitivity, specificity and accuracy in determination of depth of anesthesia were obtained by comparison with the recorded reference signals in awake, light anesthesia, deep anesthesia and brain death patients. Result: Time parameters had low accuracy in prediction of the depth of anesthesia determination. The accuracy was 75% for burst suppression response. It was higher for frequency based characteristics which the best results were in β spectral power. (Accuracy: 88.9%)The accuracy was 89.9% for synchronized fast slow bispectral characteristics. The best results were obtained from entropy based characteristics which its accuracy was 99.8%. Conclusion: Entropy based characteristics analysis have a great value in predicting the depth of anesthesia. Generally, due to the low accuracy of each single parameter in prediction depth of anesthesia, we advise multiple characteristics analysis with more persistence on entropy based characteristic. Introduction Clinical evaluation of intra operative EEG for assessment depth of anesthesia determination is very difficult. Finding some ways for better qualitative classification of recorded EEG is especially important.Until now, for assessment of depth of anesthesia, several methods according to time, frequency and bispectral characteristics have been proposed. Entropy based characteristics are also used for anesthetic stages classification (1, 2, 3) .For increasing accuracy of depth of anesthesia determination we should find brain waves characteristics which are quite different in different stages of anesthesia.In other words some characteristics are more common in a special anesthetic stage, which are different in other stages. Therefore, we have to introduce methods which can use EEG characteristics in their useful ranges. One of the factors that should be minded is the possibility of use of these characteristics in the immediate assessment of the depth of anesthesia. We want to calculate drug dose on the basis of a score attributed to a quantitative method we adopt, so we must have the least lag with the present patient status (4). In recent years, anesthesiologists have used several monitors to evaluate the depth of anesthesia. These monitors try to quantify electrical cortical activities for determination the depth of anesthesia and we named it as depth of anesthesia index. One of these monitors is BIS, introduced in 1996, BIS monitors yield a dimensionless index from EEG signals, based on Bispectral analyses which is called bispecteral index (BI) (2). In 2004 the Demeter company introduced CSM which shows cortical status index (CSI). These 2 monitors enjoy FDA approval.CSI uses 4 different characteristics in time and frequency of EEG signal as the input of Anfis system. Clinical studies show that there is a great correlation between CSI and Bis. Also Bis and CSI indices have a good correlation (92%, 93% respectively) to the clinical depth of anesthesia based on standards such as OAAS (5).EEG signals are results of neuronal electrical activities .Time, frequency, bispectral and high level spectrums are characteristics which are used for EEG signal analysis. Entropic methods are used for EEG signals too (6, 7).In this study we tried to consider EEG signal derived parameters and choose the best characteristic for several anesthesia stages' differe
机译:简介:麻醉深度的评估对于良好和有用地处理患者尤为重要。手术室脑电图的临床评估是该领域的主要困难之一。本研究试图找到最有价值的脑电参数,以预测不同阶段的麻醉深度。材料和方法:在SHOHADA-E-TAJRISH医院的所有麻醉阶段,记录了30例麻醉方法相同(全静脉内麻醉)患者的EEG数据.EEG的定量特征分为4类:时间,频率,双频谱和熵通过与清醒,轻度麻醉,深层麻醉和脑死亡患者中记录的参考信号进行比较,获得了他们在确定麻醉深度时的敏感性,特异性和准确性。结果:时间参数在预测麻醉深度时的准确性较低。突发抑制响应的准确性为75%。基于频率的特性较高,最好的结果是β频谱功率。 (精度:88.9%)同步快慢双光谱特性的精度为89.9%。最佳结果是从基于熵的特征中获得的,其准确性为99.8%。结论:基于熵的特征分析在预测麻醉深度方面具有重要价值。通常,由于每个参数在麻醉预测深度中的准确性较低,我们建议对多特征进行分析,并对基于熵的特征进行更多的保留。引言术中脑电图的临床评估对于确定麻醉深度是非常困难的。寻找更好的定性脑电图定性分类的方法尤为重要。到目前为止,为评估麻醉深度,已提出了根据时间,频率和双谱特征的几种方法。基于熵的特征也被用于麻醉阶段的分类(1,2,3)。为了提高麻醉深度的确定准确性,我们应该找到在麻醉的不同阶段有很大不同的脑电波特征,换句话说,某些特征更常见在特殊的麻醉阶段,这与其他阶段有所不同。因此,我们必须介绍可以在其有用范围内使用EEG特征的方法。应该考虑的因素之一是在立即评估麻醉深度时使用这些特征的可能性。我们希望基于归因于我们采用的定量方法的得分来计算药物剂量,因此我们必须与当前患者状况的滞后时间最小(4)。近年来,麻醉师使用了几台监视器来评估麻醉深度。这些监视器试图量化皮层电活动以确定麻醉深度,我们将其命名为麻醉深度指数。其中一种是BIS监测器,于1996年推出,BIS监测器基于双光谱分析从脑电信号产生无量纲的索引,称为双谱指数(BI)(2)。 2004年,Demeter公司推出了CSM,它可以显示皮质状态指数(CSI)。这2台监护仪均获得了FDA的认可。CSI使用4种不同的EEG信号时间和频率特性作为Anfis系统的输入。临床研究表明,CSI和Bis之间存在很大的相关性。根据OAAS(5)等标准,Bis和CSI指数与麻醉的临床深度也有很好的相关性(分别为92%,93%)。EEG信号是神经元电活动的结果,时间,频率,双频谱和高水平频谱是用于脑电信号分析的特征。熵方法也用于脑电信号(6,7)。在这项研究中,我们尝试考虑脑电信号衍生的参数,并为几个麻醉阶段的不同选择最佳特征。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号