论文标题

与TIVA相比,挥发性麻醉期间的神经活动减少:来自新型脑电图信号处理分析的证据

Reduced neural activity during volatile anesthesia compared to TIVA: evidence from a novel EEG signal processing analysis

论文作者

Bickel, Amitai, Gavrilov, Alexey, Ivry, Shimon, Maimon, Neta B, Molcho, Lior, Intrator, Nathan

论文摘要

术后认知下降是一种众所周知的现象,至关重要,尤其是在老年人中。全身麻醉可以通过基于吸入的(挥发性)或总麻醉(TIVA)来完成。尽管已经研究了它们对术后症状的影响,但对他们对手术本身对脑功能的影响知之甚少。要评估差异,将17例患者分开以接受挥发性麻醉(n = 9)或TIVA(n = 8)。两组的麻醉水平保持平等。将单个双极EEG电极(Neurosteer系统)放在参与者的额头上。它提出了实时活动,并在手术期间收集了他们的数据。因变量包括频带(Delta,Theta,Alpha和Beta),以及先前用该设备提取并由Neurosteer提供的三个特征(VC9,ST4和A0)。所有手术都很顺利,所有患者的双光谱指数(BIS)得分均低于60。在挥发性麻醉下(与TIVA相比)的特征活性在三角洲,THETA和Alpha频带和三个特征中都显着较低。进一步的分析表明,麻醉类型之间的最大差异是特征A0。 EEG频带和新型大脑活动特征提供了证据表明,与TIVA麻醉相比,挥发性麻醉进一步降低了大脑活动的成分。具体而言,以前显示与认知下降的严重程度和认知负荷相关的A0表现出麻醉类型之间最突出的差异。总之,这项研究表明,使用敏感特征测量麻醉期间的大脑活动,使您可以揭示不同的麻醉类型可能会不同地影响大脑活动,这可能会影响从麻醉中恢复,从而减少术后认知下降

Post-operative cognitive decline is a well-known phenomenon and of crucial importance especially in the elderly. General anesthesia can be accomplished by inhalation-based (volatile) or total intravenous anesthesia (TIVA). While their effects on post-operative symptoms have been investigated, little is known about their influence on brain functionalities during the surgery itself. To assess differences 17 patients were divided to receive either volatile anesthesia (n=9), or TIVA (n=8). The level of anesthesia was kept to be equal in both groups. A single bipolar EEG electrode (Neurosteer system) was placed on the participants foreheads. It presented real-time activity and collected their data during the surgery. The dependent variables included frequency bands (delta, theta, alpha, and beta), and three features (VC9, ST4, and A0) previously extracted with the device and provided by Neurosteer. All surgeries were uneventful, and all patients showed bispectral index (BIS) score less than 60. Feature activity under volatile anesthesia (in comparison to TIVA) was significantly lower for the delta, theta and alpha frequency bands and for the three features. Further analysis showed that the largest difference between anesthesia types was for feature A0. The EEG frequency bands and novel brain activity features provide evidence that volatile anesthesia further reduces components of brain activity in comparison to TIVA anesthesia. Specifically, A0, which previously showed a correlation with cognitive decline severity and cognitive load, exhibited the most prominent difference between anesthesia types. Together, this study suggests that measuring brain activity during anesthesia using sensitive features, enables revealing that different anesthesia types may affect brain activity differently, which could affect the recovery from anesthesia, and consequently reduce post-operative cognitive decline

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