Commercial testing of a physiologically based theory of oscillatory brain electrical activity in anaesthesia monitoring

虽然局部麻醉的机制已为人所熟知，但麻醉剂损害意识的机制仍未解决。这种缺乏了解的情况影响了我们监测麻醉水平的能力，同时麻醉剂的消耗和副作用被降至最低。尽管如此，一些设备已经被开发出来，试图通过量化大脑的电活动来监测麻醉的深度。所有监测员都使用通过反复试验制定的一套标准来分析活动。斯温本理工大学的大卫·莱利博士和他的团队的研究结果是，对产生脑电活动的生理机制有了详细的了解。研究结果为开展基于系统的脑电反应分析(SABER)提供了一种实用的手段。2004年，莱利博士开始与Cortical Dynamic合作，这是一家参与医疗设备商业化的公司。这项合作将Saber系统整合到一种名为大脑麻醉反应(BAR)监测器的新原型设备中。2004年，莱利博士和副教授凯特·莱斯利在皇家墨尔本医院合作进行了一项试验，以测试SABER系统在量化不同水平的一氧化二氮对麻醉深度测量的影响方面的敏感性。澳大利亚和新西兰麻醉师学院支持这项研究。使用七氟醚和3个水平的一氧化二氮获得的初步结果表明，根据更高的脑动态状态的两个生理特征，能够区分患者的意识和无意识状态。下一步需要商业产品验证(即扩大规模)，并在测试麻醉棒单元的Beta阶段深度方面进一步临床疗效。这项技术的完成将有助于该技术从小批量的原型系统转移到商业适用的设备。

While the mechanisms of local anaesthesia are comparatively well known, the mechanisms whereby anaesthetics impair consciousness remain unresolved. This lack of understanding has implications in our ability to monitor the level of anaesthesia while anaesthetic consumption and side effects are minimized. Despite this a number of devices have been developed that attempt to monitor the depth of anaesthesia by quantifying the brains electrical activity. All monitors analyse the activity using a set of criteria that have been developed by trial and error. The research of Dr David Liley and his team, at Swinburne University of Technology, has resulted in a detailed understanding of the physiological mechanisms that generate brain electrical activity. The outcome is a practical means to carry out a System Based Analysis of Brain Electrical Response (SABER). In 2004, Dr Liley began working with Cortical Dynamics, a company involved in the commercialisation of medical devices. This collaboration incorporated the SABER system into a new prototype device called the Brain Anaesthesia Response (BAR) monitor. In 2004 Dr Liley and Associate Professor Kate Leslie collaborated in a trial, at the Royal Melbourne Hospital to test the sensitivity of the SABER system in quantifying the effect that various levels of nitrous oxide have on measures of anaesthetic depth. The Australian and New Zealand College of Anaesthetists supported this study. Initial results obtained with sevoflurane and 3 levels of nitrous oxide showed the ability to differentiate between conscious and unconscious states of patients based on two physiological characterizations of higher brain dynamic state. The next step requires commercial product validation (ie scale up) and further clinical efficacy in testing beta stage depth of anaesthesia BAR units. Completion of this will help the technology move away from a low volume prototype system into a commercially applicable device.