BiSpectral Index monitoring (BiS) - Anaesthesia News：脑电双频指数（BIS）-麻醉新闻.pptVIP

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2018-06-30 发布于浙江
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BiSpectral Index monitoring (BiS) - Anaesthesia News：脑电双频指数（BIS）-麻醉新闻.ppt

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BiSpectral Index monitoring (BiS) - Anaesthesia News：脑电双频指数（BIS）-麻醉新闻

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Subconscious awareness with implicit memory Category generation, free association, stem completion 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… Clinical experience Lower oesophageal contractility Frontalis EMG Heart rate variability (Respiratory sinus arrhythmia) EEG BiS (BiSpectral index monitoring) Complex EEG parameter under development by Aspect Medical systems since 1985 using clinical data from 1500 anaesthetic regimes and 500hrs of EEG signals gathered under anaesthetics Approved by the FDA in 1996 Several hundred publications to date BiS Direct measure of the effects of anaesthetics on the brain BIS monitoring allows anaesthesia providers to administer the appropriate amount of drug that each patient needs The Bispectral IndexTM (BiS) Aspect Medical Systems Auditory Evoked Potential Auditory Evoked Potential The early cortical AEP waves called Pa and Nb, which occurs between 20 and 80 ms reflects the activity in the temporal lobe/primary auditory cortex ( the site of sound registration) Changes in the latency of these waves ( in particular the Nb wave) are highly correlated with a transition from awake to loss of consciousness Mid-latency AEP AEP Limitations: hea