Development of automatic infusion systems for sedatives and analgesics with surface EEGs and Auditory Evoked Potentials as Input Signals

开发以表面脑电图和听觉诱发电位作为输入信号的镇静镇痛药自动输注系统

• 批准号: 12671462
• 负责人: DOI Matsuyuki
• 金额: $ 2.11万
• 依托单位: Hamamatsu University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671462/
• 关键词: depth of anesthesia; automatic infusion; electroencephalograph; auditory evoked potentials; target controlled infusion; Bispectral Index; Bispectral Indes

The aim of this project was to develop automatic infusion systems which were able to control a sedative and an analgesic independently. We chose surface EEG variables and auditory evoked potentials as input signals to quantify levels of sedation and analgesia. We have performed following sub-studies to complete this project.1) Development of target controlled infusion (TCI) systems for propofol and fentanylUsing published pharmacokinetic models, we made up TCI systems which were able to control blood or effect site concentration of propofol and fentanyl independently.2) Development of a computer system to integrate surface EEG variables and auditory evoked potentialsBispectral Index (BIS) and auditory evoked potential index (AEPindex) were involved as numerical variables for surface EEG and auditory evoked potentials, respectively. BIS and AEPindex values were automatically recorded in the system.3) Investigation of the interaction of propofol and fentanyl on EEG variablesWe studied interaction of propofol and fentanyl on EEGs to develop an algorithm which could quantify level of sedation and analgesia independently.4) Investigation of an algorithm to detect awareness using BIS and AEPindexWe could detect awareness more accurately using a combination of BIS and AEPindex5) Effects of profound hypothermia on EEG variablesWe investigated stability of EEG variables down to 22 degree centigrade. We found the AEPindex was most stable among the EEG variables studied during profound hypothermia.In conclusions, we found that the combination of the surface EEG and auditory evoked potentials were useful to detect awareness more accurately, however the combination did not have enough ability to quantify level of analgesia.

该项目的目的是开发能够独立控制镇静剂和止痛剂的自动输液系统。我们选择表面EEG变量和听觉诱发电位作为输入信号来量化镇静和镇痛水平。我们进行了以下子研究来完成这个项目。1）丙泊酚和芬太尼的靶控输注（TCI）系统的开发利用已发表的药代动力学模型，2）建立了一个能独立控制异丙酚和芬太尼的血药浓度和效应部位浓度的脑靶控输注系统。以听觉诱发电位指数（AEPindex）和听觉诱发电位指数（AEPindex）作为表面脑电和听觉诱发电位的数值变量。3）异丙酚和芬太尼对脑电参数相互作用的研究我们研究了异丙酚和芬太尼对脑电的相互作用，以开发一种能够独立量化镇静和镇痛水平的算法。4）利用BIS和AEPindex检测意识的算法研究我们可以使用BIS和AEPindex的组合来更准确地检测意识5）深低温对脑电变量的影响我们研究了低至22 ℃时脑电变量的稳定性。我们发现AEP指数是最稳定的EEG变量中研究在深低温。总之，我们发现，表面EEG和听觉诱发电位的组合是有用的，以检测意识更准确，但组合没有足够的能力来量化镇痛水平。

项目成果

Matsuyuki Doi: "Analysis of the EEG bispectrum, auditory evoked potentials and the EEG power spectrum during sedation induced by propofol"ICU and CCU. 24(8). 591-598 (2000)

Matsuyuki Doi：“异丙酚诱导镇静期间脑电图双谱、听觉诱发电位和脑电图功率谱的分析”ICU 和 CCU。

土井松幸: "皮質脳波,聴性誘発電位による鎮静度評価"ICUとCCU. 24・8. 591-598 (2000)

Matsuyuki Doi：“使用皮质脑电图和听觉诱发电位评估镇静水平” ICU和CCU 591-598（2000）。

Matsuyuki Doi: "The combination of AEPex and BIS improves accuracy to detect awareness during propofol anaesthesia"Journal of Clinical Monitoring and Computing. 17・1. 79-80 (2002)

Matsuyuki Doi：“AEPex 和 BIS 的结合提高了丙泊酚麻醉期间检测意识的准确性”《临床监测与计算杂志》17・1 (2002)。

Matsuyuki Doi: "The combination of AEPex and BIS improves accuracy to detect awareness during propofol anaesthesia"Journal of Clinical Monitoring and Computing. 17(1), 2002. 79-80 (2002)

Matsuyuki Doi：“AEPex 和 BIS 的结合提高了丙泊酚麻醉期间检测意识的准确性”《临床监测与计算杂志》。

Tadayoshi Kurita: "Auditory evoked potential index predicts the depth of sedation and movement in response to skin incision during sevoflurane anesthesia"Anesthesiology. 95・2. 364-370 (2001)

Tadayoshi Kurita：“听觉诱发电位指数预测七氟烷麻醉期间皮肤切口的镇静和运动深度”麻醉学 95・2（2001）。