Anders Aasheim, Leiv Arne Rosseland, Ann-Chatrin Linqvist Leonardsen, Luis Romundstad
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Participation was voluntary and anonymized, and the web form could not track IP sources or respondents' locations.</p><p><strong>Results: </strong>Three hundred and ninety-one nurse anesthetists (n = 324) and anesthesiologists (n = 67) responded. Among the EEG-based DoA monitoring tools, BIS was most often used to observe and assess patients' DoA (98%). Raw EEG waveform analysis (10%), EEG-spectrogram (9%), and suppression rate (10%) were seldom used. Twenty-seven percent of the anesthesia personnel were able to recognize a burst suppression pattern on EEG and its significance. Fifty-eight percent of the respondents considered clinical observations more reliable than BIS. Almost all respondents reported adjusting anesthetic dosage based on the BIS index values (80%). However, the anesthetic dose was more often increased (90%) because of high BIS index values than lowered (55%) because of low BIS index values.</p><p><strong>Conclusion: </strong>Despite our respondents' extensive use of DoA monitoring, the anesthesia personnel in our survey did not use all the information and the potential to guide the titration of anesthetics the DoA monitors provide. 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引用次数: 0
摘要
背景:双谱指数(BIS)监测仪是挪威医院最常用的基于脑电图(EEG)的麻醉深度(DoA)技术。然而,人们对其使用程度和临床影响以及麻醉医师和麻醉护士在临床实践中如何使用麻醉深度监测仪提供的信息了解有限:这项关于挪威 DoA 监护仪使用情况的横断面调查采用了网络问卷的形式,向挪威所有医院的麻醉人员发放了问卷。参与是自愿和匿名的,网络表格无法追踪 IP 来源或受访者的所在地:结果:391 名麻醉护士(n = 324)和麻醉医师(n = 67)做出了回应。在基于脑电图的 DoA 监测工具中,BIS 最常用于观察和评估患者的 DoA(98%)。很少使用原始脑电图波形分析(10%)、脑电图频谱图(9%)和抑制率(10%)。27% 的麻醉人员能够识别脑电图上的爆发抑制模式及其意义。58%的受访者认为临床观察比 BIS 更可靠。几乎所有受访者都表示会根据 BIS 指数值调整麻醉剂量(80%)。然而,因 BIS 指数值高而增加麻醉剂量的比例(90%)高于因 BIS 指数值低而减少麻醉剂量的比例(55%):尽管受访者广泛使用 DoA 监测,但在我们的调查中,麻醉人员并未利用 DoA 监测仪提供的所有信息和潜力来指导麻醉剂的滴定。因此,如果麻醉人员能更多地了解如何使用基于脑电图的 DoA 监测来评估和确定患者对麻醉药物的需求,他们将普遍受益。
Depth of anesthesia monitoring in Norway-A web-based survey.
Background: The bispectral index (BIS) monitor is the most frequently used electroencephalogram (EEG)-based depth of anesthesia (DoA) technology in Norwegian hospitals. However, there is limited knowledge regarding the extent and clinical impact of its use and how anesthesiologists and nurse anesthetists use the information provided by the DoA monitors in their clinical practice.
Methods: This cross-sectional survey on the use of DoA monitors in Norway used a web-based questionnaire distributed to anesthesia personnel in all hospitals in Norway. Participation was voluntary and anonymized, and the web form could not track IP sources or respondents' locations.
Results: Three hundred and ninety-one nurse anesthetists (n = 324) and anesthesiologists (n = 67) responded. Among the EEG-based DoA monitoring tools, BIS was most often used to observe and assess patients' DoA (98%). Raw EEG waveform analysis (10%), EEG-spectrogram (9%), and suppression rate (10%) were seldom used. Twenty-seven percent of the anesthesia personnel were able to recognize a burst suppression pattern on EEG and its significance. Fifty-eight percent of the respondents considered clinical observations more reliable than BIS. Almost all respondents reported adjusting anesthetic dosage based on the BIS index values (80%). However, the anesthetic dose was more often increased (90%) because of high BIS index values than lowered (55%) because of low BIS index values.
Conclusion: Despite our respondents' extensive use of DoA monitoring, the anesthesia personnel in our survey did not use all the information and the potential to guide the titration of anesthetics the DoA monitors provide. Thus, anesthesia personnel could generally benefit from increased knowledge of how EEG-based DoA monitoring can be used to assess and determine individual patients' need for anesthetic medication.
期刊介绍:
Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.