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

虽然局部麻醉的机制相对来说是众所周知的，但麻醉损害意识的机制仍然没有解决。这种认识的缺乏影响了我们在麻醉药消耗和副作用最小化的同时监测麻醉水平的能力。尽管如此，仍有许多设备被开发出来，试图通过量化大脑的电活动来监测麻醉的深度。所有监督员都使用一套通过试错制定的标准来分析活动。斯威本科技大学的大卫·利利博士和他的研究小组对产生脑电活动的生理机制有了详细的了解。该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，Liley博士开始与皮质动力公司合作，这是一家从事医疗设备商业化的公司。这次合作将SABER系统整合到一个名为脑麻醉反应（BAR）监测器的新原型设备中。2004年，利利博士和凯特·莱斯利副教授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氧化亚氮对麻醉深度测量的影响方面的灵敏度。澳大利亚和新西兰麻醉师学院支持这项研究。七氟醚和三次氧化亚氮的初步结果表明，根据高脑动态状态的两种生理特征，可以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）和进一步的临床疗效测试，以测试麻醉BAR装置的β阶段深度。这项工作的完成将有助于该技术从小批量原型系统转变为商业应用设备。

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.