脑电图抑制持续时间不能预测志愿者全身麻醉恢复时间及认知障碍程度
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Duration of EEG suppression does not predict recovery time or degree of cognitive impairment after general anaesthesia in human volunteers
背景与目的
昏迷和全身麻醉时，脑电图波会出现爆发抑制。据推测爆发抑制是一种较难恢复的深麻醉状态，然而并没有直接证明。本研究探讨脑电图爆发抑制与志愿者麻醉后意识恢复的关系。
方 法
本研究纳入了27名健康志愿者（9名女性/18名男性），用1.3 MAC异氟醚麻醉3小时，麻醉期间记录脑电图。利用频谱成分分析法计算脑电图抑制和非抑制的持续时间。参与者完成了数字符号替换测试和精神运动警惕测试试验。
结 果
受试者表现出受抑制脑电图多种特征的显著变异性。为了验证上述假设，对于个体，为提高将脑电图抑制特征与预测恢复时间的关系而构建了两种精确模型：一种包含抑制相关特征，另一种不包含抑制相关特征。与我们的假设相反，增加脑电图爆发抑制相关特征并不能提高模型预测恢复时间的能力。此外，与麻醉前相比，脑电图爆发抑制量和认知功能下降没有相关性。
结 论
脑电波爆发抑制并不是健康成人麻醉后恢复时间或认知障碍程度的决定因素。
原始文献摘要
Shortal BP, Hickman LB, Mak-McCully RA,etal. Duration of EEG suppression does not predict recovery time or degree of cognitive impairment after general anaesthesia in human
volunteers. Br J Anaesth. 2019 Jun 12. PMID: 31202561.
Background: Burst suppression occurs in the EEG during coma and under general anaesthesia. It has been assumed that burst suppression represents a deeper state of anaesthesia from which it is more diffificult to recover. This has not been directly
demonstrated, however. Here, we test this hypothesis directly by assessingrelationships between EEG suppression in human volunteers and recovery of consciousness.
Methods: We recorded the EEG of 27 healthy humans (nine women/18 men) anaesthetised with isoflflurane 1.3 minimum alveolar concentration (MAC) for 3 h. Periods of EEG suppression and non-suppression were separated using principal component analysis of the spectrogram. After emergence, participants completed the digit symbol substitution test and the psychomotor vigilance test.
Results: Volunteers demonstrated marked variability in multiple features of the suppressed EEG. In order to test the hypothesis that, for an individual subject, inclusion of features of suppression would improve accuracy of a model built to predict time of emergence, two types of models were constructed: one with a suppression-related feature included and one without. Contrary to our hypothesis, Akaike information criterion demonstrated that the addition of a suppression-related feature did not improve the ability of the model to predict time to emergence. Furthermore, the amounts of EEG suppression and decrements in cognitive task performance relative to pre-anaesthesia baseline were not signifificantly correlated.
Conclusions: These fifindings suggest that, in contrast to current assumptions, EEG suppression in and of itself is not an important determinant of recovery time or the degree of cognitive impairment upon emergence from anaesthesia in healthy adults.
麻醉学文献进展分享
贵州医科大学高鸿教授课题组
翻译：王贵龙 编辑：何幼芹 审校：王贵龙