CN102793534A - Anesthesia depth monitoring device and method - Google Patents
Anesthesia depth monitoring device and method Download PDFInfo
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Abstract
The invention aims to provide an anesthesia depth monitoring device and an anesthesia depth monitoring method. According to the anesthesia depth monitoring device disclosed by the invention, by carrying out analysis and transverse comparison on a bispectral index, noxious stimulation data and neuromuscular blockade depth data, injection medicine is respectively controlled, the interference of the neuromuscular blockade recovery and the noxious stimulation strengthening on the electroencephalogram monitoring anesthesia depth is effectively eliminated and the monitoring on the electroencephalogram anesthesia depth can accurately and effectively reflect an anesthesia depth value of a patient. Meanwhile, by the anesthesia control of carrying out interference elimination on the monitoring on the electroencephalogram anesthesia depth and then carrying out optimization, the anesthesia depth can be controlled stable like a straight line, the machine control of the integral anesthesia process is implemented, the condition of judging the anesthesia process mainly by the anesthesia experience of a doctor is changed, the influence of the individual difference of patients is overcome, the safety of the anesthesia process is furthest ensured and the anesthesia depth monitoring device and the anesthesia depth monitoring method have high social values and a wide application prospect.
Description
Technical field
The present invention relates to computer realm, be specifically related to a kind of depth of anesthesia supervising device and method.
Background technology
According to clinical statistics, approximately have only 60% patient can enjoy complete fine anesthesia service, about 14% patient is by excessively anesthesia, and 16% patient anaesthetized shallow, and was dark when shallow when 10% patient is in.
Anaesthetized shallowly, patient possibly have memory even feel pain operation, and serious also can cause spirit or sleep disorder, and " terrified recall " that possibly cause in the art becomes the another misery of postoperative life; And anaesthetized deeply, and possibly cause neural sequela, postoperative has sense of discomfort for a long time, even threat to life.
Sedation anesthesia is dark excessively, and overdose can cause that breathing is slack-off, to respiratory arrest, and big cerebral anoxia, the brain long term hypoxia causes that heart of patient stops, and causes patient death.Anaesthetized shallowly, and caused in the art and know, patient possibly have memory even feel pain operation, and serious also can cause spirit or sleep disorder, and " terrified recall " that possibly cause in the art becomes the another misery of postoperative life; Know the recovery that consciousness also promptly takes place in the operation process in the art under general anesthesia.Under this situation, can there be consciousness in the patient, can hear the sound of surrounding, but any motion of uncontrollable limbs for example comprises and opens eyes, coughs.It is 0.1-0.2% that its incidence rate of report is arranged.Calculate according to this ratio, the U.S. has 20,000,000 people to accept general anesthesia operation every year, will have 20,000 to 40,000 people to take place to know in the art.This number is enough to cause the concern of the public and medium.Domestic also have investigation and an analysis of knowing in the Rhizoma Atractylodis Macrocephalae of similar pass, and the operation of intracranial tumor awareness is 1%, the non-brain of non-heart section operation awareness 2%, and the operation on heart awareness is up to 6%.
The harmful effect of knowing in the art: know in the art and bring recent and even secular harmful effect can for the patient who implements to anaesthetize because of operation.Comprise: bad dream, insomnia, fear; Flashback, traumatic psychentonia sexual disorders, the patient who has even be diagnosed as schizophrenia; Some possibly develop into abalienation syndrome after the wound, and the persistent period is long, needs to give and Drug therapy or psychological counseling.
Cross shallow or dark excessively incidence rate in order to reduce the anesthesia medication, just need the monitoring depth of anesthesia.General anesthesia depth monitoring main purpose is: confirm depth of anesthesia, survey central nervous system's state; Avoid simultaneously knowing in the art, avoid patient's postoperative that memory is arranged, reduce the anaesthetic consumption simultaneously, shorten the recovery process, improve anesthesia safety, must carry out the monitoring of depth of anesthesia, monitoring depth of anesthesia through the eeg monitoring index at present is the most extensively to adopt mode.
(Bispectral index is to have comprised frequency, amplitude, the position electroencephalogram quantitative analysis index of 3 specific characters mutually BIS) to brain electricity bispectral index, mainly reflects the phase place coupling between the EEG signal medium frequency, is a kind of complex indexes.It mainly comes the degree of contact of quantitative different cerebral signal of telecommunication frequency with 0-100.
In a research, inform that the anesthesia personnel keeps brain electricity bispectral index value 40～60, avoid brain electricity bispectral index value to surpass 60 inducing with the maintenance stage; This anesthesia management mode benefits significantly: tried among the patient in 4945 examples, promptly begin to monitor brain electricity bispectral index before the induction of anesthesia, from inserting laryngoscope to the overall process of stitching skin, brain electricity bispectral index value all maintains between 40～60, controls administration.This measure has as a result reduced by 82% with knowing incidence rate in the art
But, make the electrical index of requiring mental skill monitor the real depth of anesthesia of reflection patient that depth of anesthesia sometimes can not be correct.Point out that when the neuromuscular activity increased under the narcotism, brain electricity bispectral index can not accurately reflect narcotism after many parts of case reports of summary such as Germany Panousis.Researcher adds when giving the end-tidal desflurane with breast section epidural anesthesia and eases pain including case in, and through PRST scoring, OAA/S scale and BIS XP monitor monitoring depth of anesthesia.The result shows; Patient's myoelectrical activity obviously strengthens; This prompting neuromuscular blockade effect disappears, and this moment, its brain electricity bispectral index value increased to 70 ~ 80 from 40 ~ 55, after this prompting depth of anesthesia maybe be not enough transfers to 1 MAC according to the age with the end-tidal administration concentration of desflurane; Brain electricity bispectral index value is no change still, and intravenous injection remifentanil hindbrain electricity bispectral index value is no change also.Though brain electricity bispectral index can play suggesting effect to myoelectrical activity, if myoelectrical activity>35 dB, the monitoring of brain electricity bispectral index can not accurately reflect depth of anesthesia.
Simultaneously show that based on multinomial research the increase of noxious stimulation also can obviously cause the increase of brain electrical index, do not represent depth of anesthesia not enough, just analgesic is not enough, and the eeg monitoring numerical value of this moment can not accurately reflect depth of anesthesia.
This moment if the Anesthetist based on the prompting of monitoring numerical value feedack: depth of anesthesia is not enough, strengthens the dosage of sedation anesthesia medicine, and it is dark excessively can to surpass into anesthesia on the contrary.And anaesthetized deeply, and possibly cause neural sequela, postoperative has sense of discomfort for a long time, even threat to life.
Therefore, anaesthetize the experience that needs to rely on the Anesthetist under a lot of situation at present clinically, judge which kind of medicine that when gives what amount.Because Anesthetist's experience and technical ability difference, and patient's individual variation tend to bring unforeseen risk to the anesthesia process.
Summary of the invention
The present invention relates to computer realm, be specifically related to a kind of depth of anesthesia supervising device and method.Depth of anesthesia supervising device provided by the invention and method can effectively get rid of because the inaccurate problems of anesthesia depth monitoring numerical value that interference caused such as neuromuscular moving obstacle and the enhancings of operation noxious stimulation.
Depth of anesthesia supervising device of the present invention comprises:
Data reception module is used to receive brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data;
Data analysis module is to the brain received electricity bispectral index, noxious stimulation data, the neuromuscular blockade depth data is analyzed and laterally contrast, confirms the generation reason of brain electricity bispectral index fluctuation;
The control output module, according to the data analysis result, output administration parameter information, the dosage of control analgesic, muscle relaxants and downern.
Depth of anesthesia supervising device of the present invention also comprises synchronous curve module, is used to set up brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof.
Depth of anesthesia supervising device of the present invention, the structure of each module is following:
Data reception module comprises that brain electricity bispectral index is accepted submodule, the noxious stimulation data are accepted submodule, neuromuscular blockade depth data reception submodule, is respectively applied for and receives brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data;
Data analysis module comprises brain electricity bispectral index analysis submodule, noxious stimulation data analysis submodule, neuromuscular blockade depth data analysis submodule; Through the analysis of three sub-module and laterally contrast, confirm the generation reason of brain electricity bispectral index fluctuation;
The control output module comprises target control operator module, injection control submodule; Target control operator module is calculated target control administration parameter according to bispectral index fluctuation of brain electricity and reason thereof; Injection control submodule is controlled the dosage of analgesic, muscle relaxants and downern according to the administration parameter.
Depth of anesthesia supervising device of the present invention, the brain electricity bispectral index analysis submodule in the data analysis module, noxious stimulation data analysis submodule, neuromuscular blockade depth data are analyzed submodule and are set bound fault value respectively;
Noxious stimulation data analysis submodule if the noxious stimulation data are lower than lower limit fault value, transfers data to target control operator module, calculates the analgesic dosage that needs reduction, through the minimizing of injection control submodule control analgesic; If the noxious stimulation data are higher than upper limit fault value, transfer data to target control operator module, calculate the analgesic dosage that needs increase, through the increase of injection control submodule control analgesic;
The neuromuscular blockade depth data is analyzed submodule; If the neuromuscular blockade depth data is lower than lower limit fault value; Transfer data to target control operator module, calculate the muscle relaxants dosage that needs reduction, through the minimizing of injection control submodule control muscle relaxants; If the neuromuscular blockade depth data is higher than upper limit fault value, transfer data to target control operator module, calculate the muscle relaxants dosage that needs increase, through the increase of injection control submodule control muscle relaxants;
Brain electricity bispectral index is analyzed submodule, if noxious stimulation data and neuromuscular blockade depth data all do not exceed preset bound fault value, brain electricity bispectral index is judged; If brain electricity bispectral index is lower than lower limit fault value, transfer data to target control operator module, calculate the downern dosage that needs reduction, through the minimizing of injection control submodule control downern; If brain electricity bispectral index transfers data to target control operator module according to being higher than upper limit fault value, calculate the downern dosage that needs increase, through the increase of injection control submodule control downern.
Described injection control submodule promotes actuating device through motor and syringe and realizes the regulation and control to dosage.
Described motor and syringe promote actuating device one and have three covers, form A, B, three passages of C respectively, and what passage A carried is downern, and what channel B was carried is analgesic, and what channel C was carried is muscle relaxants.
Depth of anesthesia supervising device of the present invention; Comprise anesthesia monitor, anesthesia monitor is a prior art, such as the Datex-ohmeda anesthesia monitor of U.S. GE company; Obtain brain electricity bispectral index and noxious stimulation data through the anesthesia monitor monitoring, transfer to data reception module.
The depth of anesthesia supervising device that the present invention protected also comprises the neuromuscular monitoring device, is called " closed loop muscle pine injection device ", the technology of the patent No. for putting down in writing in the Chinese utility model patent of " 201020152817.8 " like name; The neuromuscular monitoring device is made up of neuromuscular monitoring stimulating unit and neuromuscular monitoring pick off; The neuromuscular monitoring stimulating unit stimulates wrist ulnar nerve monitoring adductor pollicis, obtains the neuromuscular blockade depth data through neuromuscular monitoring sensor in real time monitoring neuromuscular blockade degree, transfers to data reception module.
The S/5 anesthesia monitor that GE company has gone on the market also can be monitored the neuromuscular blockade degree, obtains the neuromuscular blockade depth data, also can combine technical scheme of the present invention, as the source of neuromuscular blockade depth data.
Depth of anesthesia method for supervising of the present invention has used depth of anesthesia supervising device of the present invention; Utilization outreaches monitoring of equipment and goes out brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data; Receive brain electricity bispectral index, noxious stimulation data, neuromuscular blockade depth data through described depth of anesthesia supervising device; And to brain electricity bispectral index, noxious stimulation data, the neuromuscular blockade depth data is analyzed and laterally contrast, confirms the generation reason of brain electricity bispectral index fluctuation; Control the administration of analgesic, muscle relaxants and downern then by described depth of anesthesia supervising device.
Depth of anesthesia method for supervising of the present invention comprises following preferred steps:
⑴, obtain brain electricity bispectral index and noxious stimulation data, transfer to data reception module, obtain the neuromuscular blockade depth data, transfer to data reception module through the neuromuscular monitoring device through anesthesia monitor monitoring;
⑵, digital data receiver module comprise that brain electricity bispectral index is accepted submodule, the noxious stimulation data are accepted submodule, neuromuscular blockade depth data reception submodule; Be respectively applied for and receive brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data, transfer to data analysis module;
⑶, data analysis module comprise data brain electricity bispectral index analysis submodule, noxious stimulation data analysis submodule, neuromuscular blockade depth data analysis submodule; Three sub-module are to the brain that receives electric bispectral index, noxious stimulation data and the neuromuscular blockade depth data is analyzed and laterally contrast, confirm the generation reason of brain electricity bispectral index fluctuation, transfer to the control output module;
⑷, control output module comprise target control operator module, injection control submodule; Target control operator module is calculated target control administration parameter according to bispectral index fluctuation of brain electricity and reason thereof; Injection control submodule is controlled the dosage of analgesic, muscle relaxants and downern according to the administration parameter.
Depth of anesthesia method for supervising of the present invention comprises following further preferred steps:
Described injection control submodule promotes actuating device through control step motor and syringe and realizes the regulation and control to dosage; Motor and syringe promote actuating device one and have three covers; Form A, B, three passages of C respectively; What passage A carried is downern, and what channel B was carried is analgesic, and what channel C was carried is muscle relaxants;
Noxious stimulation data analysis submodule if the noxious stimulation data are lower than lower limit fault value, transfers data to target control operator module, calculates the analgesic dosage that needs reduction, reduces the dosage of analgesic through injection control submodule control channel B; If the noxious stimulation data are higher than upper limit fault value, transfer data to target control operator module, calculate the analgesic dosage that needs increase, increase the dosage of analgesic through injection control submodule control channel B;
The neuromuscular blockade depth data is analyzed submodule; If the neuromuscular blockade depth data is lower than lower limit fault value; Transfer data to target control operator module, calculate the muscle relaxants dosage that needs reduction, reduce the dosage of muscle relaxants through injection control submodule control channel C; If the neuromuscular blockade depth data is higher than upper limit fault value, transfer data to target control operator module, calculate the muscle relaxants dosage that needs increase, increase the dosage of muscle relaxants through injection control submodule control channel C;
Brain electricity bispectral index is analyzed submodule, if noxious stimulation data and neuromuscular blockade depth data all do not exceed preset bound fault value, brain electricity bispectral index is judged; If brain electricity bispectral index is lower than lower limit fault value, transfer data to target control operator module, calculate the downern dosage that needs reduction, reduce the dosage of downern through injection control submodule control channel A; If brain electricity bispectral index transfers data to target control operator module according to being higher than upper limit fault value, calculate the downern dosage that needs increase, increase the dosage of downern through injection control submodule control channel A.
Depth of anesthesia method for supervising of the present invention through synchronous curve module, is set up brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof.
Noxious stimulation data of the present invention comprise the data of blood pressure data, HRV data HRV or other clinical practices.
Neuromuscular blockade depth data of the present invention comprises in train of four stimulation data TOF, the train of four stimulation data data of ballism reaction height data T1 for the first time or other clinical practices.
Depth of anesthesia supervising device of the present invention; Through analyzing neuromuscular moving obstacle and this two big data message of operation noxious stimulation; Analyze the contrast computing, control injectable drug respectively, realize that neuromuscular moving obstacle and noxious stimulation are influenced interference factor drops to minimum.Anesthesia control after process was optimized again after brain electric anesthesia depth monitoring was disturbed through elimination; Can make depth of anesthesia control stablely as straight line; Realize the machine control of anesthesia overall process, changed the anesthesia process and mainly relied on doctor's anesthesia experience to judge this situation, overcome the influence of individual patient difference; Guarantee the safety of anesthesia process to greatest extent, had extraordinary social value and application prospect.
Description of drawings
Fig. 1 is the structural representation of the depth of anesthesia supervising device that provides of the embodiment of the invention
Fig. 2 is the sketch map of each hardware module of depth of anesthesia supervising device collocation of providing of the embodiment of the invention
Fig. 3 is the Monitoring Data that provides of the embodiment of the invention and the synchronous curve chart of corresponding administration parameter thereof
Fig. 4 is another kind of Monitoring Data and the corresponding administration parameter synchronization curve chart thereof that the embodiment of the invention provides
The specific embodiment
Below in conjunction with the accompanying drawing and the specific embodiment the present invention is explained further details:
As shown in Figure 1, the anesthesia monitor monitoring obtains brain electricity bispectral index and noxious stimulation data, transfers to data reception module, and the neuromuscular monitoring device obtains the neuromuscular blockade depth data, transfers to data reception module;
The digital data receiver module comprises that brain electricity bispectral index is accepted submodule, the noxious stimulation data are accepted submodule, neuromuscular blockade depth data reception submodule; Be respectively applied for and receive brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data, transfer to data analysis module;
Data analysis module comprises data brain electricity bispectral index analysis submodule, noxious stimulation data analysis submodule, neuromuscular blockade depth data analysis submodule; Three sub-module are to the brain that receives electric bispectral index, noxious stimulation data and the neuromuscular blockade depth data is analyzed and laterally contrast, confirm the generation reason of brain electricity bispectral index fluctuation, transfer to the control output module;
The control output module comprises target control operator module, injection control submodule; Target control operator module is calculated target control administration parameter according to bispectral index fluctuation of brain electricity and reason thereof; Injection control submodule is controlled the dosage of analgesic, muscle relaxants and downern according to the administration parameter.
As shown in Figure 2; Injection control submodule promotes actuating device through control step motor and syringe and realizes the regulation and control to dosage; Motor and syringe promote actuating device one and have three covers, form A, B, three passages of C respectively, and what passage A carried is downern; What channel B was carried is analgesic, and what channel C was carried is muscle relaxants;
Noxious stimulation data analysis submodule if the noxious stimulation data are lower than lower limit fault value, transfers data to target control operator module, calculates the analgesic dosage that needs reduction, reduces the dosage of analgesic through injection control submodule control channel B; If the noxious stimulation data are higher than upper limit fault value, transfer data to target control operator module, calculate the analgesic dosage that needs increase, increase the dosage of analgesic through injection control submodule control channel B;
The neuromuscular blockade depth data is analyzed submodule; If the neuromuscular blockade depth data is lower than lower limit fault value; Transfer data to target control operator module, calculate the muscle relaxants dosage that needs reduction, reduce the dosage of muscle relaxants through injection control submodule control channel C; If the neuromuscular blockade depth data is higher than upper limit fault value, transfer data to target control operator module, calculate the muscle relaxants dosage that needs increase, increase the dosage of muscle relaxants through injection control submodule control channel C;
Brain electricity bispectral index is analyzed submodule, if noxious stimulation data and neuromuscular blockade depth data all do not exceed preset bound fault value, brain electricity bispectral index is judged; If brain electricity bispectral index is lower than lower limit fault value, transfer data to target control operator module, calculate the downern dosage that needs reduction, reduce the dosage of downern through injection control submodule control channel A; If brain electricity bispectral index transfers data to target control operator module according to being higher than upper limit fault value, calculate the downern dosage that needs increase, increase the dosage of downern through injection control submodule control channel A.
As shown in Figure 3, the curve module is set up out brain electricity bispectral index, blood pressure data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof synchronously.From top to bottom, be respectively: A channel is a brain electricity bispectral index target control curve chart, B passage blood pressure data target control curve chart, and C-channel is ballism reaction height data T1 target control first time curve chart in the train of four stimulation data of the reflection neuromuscular blockade degree of depth.The X axle of each curve chart all is the time, and the time coordinate width is consistent, is synchrodata.
The Y axle of curve chart is two coordinates, and A passage-zigzag wave line representes that brain electricity bispectral index detects data, respective coordinates on the left side; Step curve is represented downern target control concentration, and respective coordinates on the right.
B passage-zigzag wave line is represented blood pressure data, reflection noxious stimulation data, respective coordinates on the left side; Step curve is represented analgesic target control concentration, and respective coordinates on the right.
C passage-zigzag wave line is represented in the train of four stimulation data ballism reaction height data for the first time, respective coordinates on the left side; Step curve is represented muscle relaxants feedback injection data, and respective coordinates on the right.
Curve chart can reflect brain electricity bispectral index, noxious stimulation data and analysis of neuromuscular blockade depth data and horizontal correlated principle through vertically contrast, and the work process that the embodiment curve chart shows is following:
⑴, 7 minutes the time, monitor that ballism reaction height data are normal for the first time in blood pressure data and the train of four stimulation data, brain electricity bispectral index is greater than preset upper limit value, and the control of control A channel strengthens the downern injection;
⑵, 25 minutes the time, monitor in the train of four stimulation data for the first time that ballism reaction height data strengthen the muscle relaxants injection greater than preset upper limit value, the control C-channel strengthens the muscle relaxants injection, prevents to disturb the monitoring of brain electricity bispectral index;
⑶, 40 minutes the time, monitor that ballism reaction height data are normal for the first time in blood pressure data and the train of four stimulation data, brain electricity bispectral index is still greater than preset value, and the control A channel strengthens the downern injection;
⑷ when, 44 minutes and 60 minutes, monitor blood pressure data greater than preset upper limit value, control B passage strengthens the analgesic injection;
⑸, 50 timesharing in 1 hour, operation finishes, and stops to inject the A channel downern.
As shown in Figure 4, the curve module is set up out brain electricity bispectral index, HRV data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof synchronously.
From top to bottom; Be respectively: A channel is a brain electricity bispectral index target control curve chart; The B passage is the HRV data target control curve chart of reflection noxious stimulation situation, C-channel for the reflection neuromuscular blockade degree of depth the train of four stimulation data in ballism reaction height data T1 target control curve chart for the first time.The X axle of each curve chart all is the time, and the time coordinate width is consistent, is synchrodata.
The Y axle of curve chart is two coordinates, and A passage-zigzag wave line representes that brain electricity bispectral index detects data, respective coordinates on the left side; Step curve is represented downern target control concentration, and respective coordinates on the right.
B passage-zigzag wave line is represented the HRV data, reflection noxious stimulation data, respective coordinates on the left side; Step curve is represented analgesic target control concentration, and respective coordinates on the right.
C passage-zigzag wave line is represented in the train of four stimulation data ballism reaction height digital data for the first time, respective coordinates on the left side; Step curve is represented muscle relaxants feedback injection data, and respective coordinates on the right.
Curve chart can reflect brain electricity bispectral index, noxious stimulation data and analysis of neuromuscular blockade depth data and horizontal correlated principle through vertically contrast, and the work process that the embodiment curve chart shows is following:
⑴, 7 minutes the time, monitor that ballism reaction height data are normal for the first time in HRV data and the train of four stimulation data, brain electricity bispectral index is greater than preset upper limit value, and the control of control A channel strengthens the downern injection;
⑵, 25 minutes the time, monitor in the train of four stimulation data for the first time that ballism reaction height data strengthen the muscle relaxants injection greater than preset upper limit value, control c passage strengthens the muscle relaxants injection, prevents to disturb the monitoring of brain electricity bispectral index;
⑶, 40 minutes the time, monitor that ballism reaction height data are normal for the first time in HRV data and the train of four stimulation data, brain electricity bispectral index is still greater than preset value, and the control A channel strengthens the downern injection;
⑷ when, 44 minutes and 60 minutes, monitor the HRV data greater than preset upper limit value, control B passage strengthens the analgesic injection;
⑸, 50 timesharing in 1 hour, operation finishes, and stops to inject the A channel downern.
Claims (14)
1. a depth of anesthesia supervising device is characterized in that, comprising:
Data reception module is used to receive brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data;
Data analysis module is to the brain received electricity bispectral index, noxious stimulation data, the neuromuscular blockade depth data is analyzed and laterally contrast, confirms the generation reason of brain electricity bispectral index fluctuation;
The control output module, according to the data analysis result, output administration parameter information, the dosage of control analgesic, muscle relaxants and downern.
2. depth of anesthesia supervising device as claimed in claim 1 is characterized in that: also comprise synchronous curve module, be used to set up brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof.
3. depth of anesthesia supervising device as claimed in claim 1 is characterized in that:
Data reception module comprises that brain electricity bispectral index is accepted submodule, the noxious stimulation data are accepted submodule, neuromuscular blockade depth data reception submodule, is respectively applied for and receives brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data;
Data analysis module comprises brain electricity bispectral index analysis submodule, noxious stimulation data analysis submodule, neuromuscular blockade depth data analysis submodule; Through the analysis of three sub-module and laterally contrast, confirm the generation reason of brain electricity bispectral index fluctuation;
The control output module comprises target control operator module, injection control submodule; Target control operator module is calculated target control administration parameter according to bispectral index fluctuation of brain electricity and reason thereof; Injection control submodule is controlled the dosage of analgesic, muscle relaxants and downern according to the administration parameter.
4. depth of anesthesia supervising device according to claim 3 is characterized in that:
Brain electricity bispectral index analysis submodule in the data analysis module, noxious stimulation data analysis submodule, neuromuscular blockade depth data are analyzed submodule and are set bound fault value respectively;
Noxious stimulation data analysis submodule if the noxious stimulation data are lower than lower limit fault value, transfers data to target control operator module, calculates the analgesic dosage that needs reduction, through the minimizing of injection control submodule control analgesic; If the noxious stimulation data are higher than upper limit fault value, transfer data to target control operator module, calculate the analgesic dosage that needs increase, through the increase of injection control submodule control analgesic;
The neuromuscular blockade depth data is analyzed submodule; If the neuromuscular blockade depth data is lower than lower limit fault value; Transfer data to target control operator module, calculate the muscle relaxants dosage that needs reduction, through the minimizing of injection control submodule control muscle relaxants; If the neuromuscular blockade depth data is higher than upper limit fault value, transfer data to target control operator module, calculate the muscle relaxants dosage that needs increase, through the increase of injection control submodule control muscle relaxants;
Brain electricity bispectral index is analyzed submodule, if noxious stimulation data and neuromuscular blockade depth data all do not exceed preset bound fault value, brain electricity bispectral index is judged; If brain electricity bispectral index is lower than lower limit fault value, transfer data to target control operator module, calculate the downern dosage that needs reduction, through the minimizing of injection control submodule control downern; If brain electricity bispectral index transfers data to target control operator module according to being higher than upper limit fault value, calculate the downern dosage that needs increase, through the increase of injection control submodule control downern.
5. like claim 3 or 4 described depth of anesthesia supervising devices, it is characterized in that: described injection control submodule promotes actuating device through motor and syringe and realizes the regulation and control to dosage.
6. depth of anesthesia supervising device as claimed in claim 5; It is characterized in that: described motor and syringe promote actuating device one and have three covers; Form A, B, three passages of C respectively; What passage A carried is downern, and what channel B was carried is analgesic, and what channel C was carried is muscle relaxants.
7. like any described depth of anesthesia supervising device in the claim 1,3 or 4, it is characterized in that: comprise anesthesia monitor, obtain brain electricity bispectral index and noxious stimulation data, transfer to data reception module through the anesthesia monitor monitoring.
8. depth of anesthesia supervising device as claimed in claim 7 is characterized in that: described noxious stimulation data comprise blood pressure data or HRV data.
9. like any described depth of anesthesia supervising device in the claim 1,3 or 4, it is characterized in that: also comprise the neuromuscular monitoring device, the neuromuscular monitoring device is made up of neuromuscular monitoring stimulating unit and neuromuscular monitoring pick off; The neuromuscular monitoring stimulating unit stimulates wrist ulnar nerve monitoring adductor pollicis, obtains the neuromuscular blockade depth data through neuromuscular monitoring sensor in real time monitoring neuromuscular blockade degree, transfers to data reception module.
10. depth of anesthesia supervising device as claimed in claim 9 is characterized in that: described neuromuscular blockade depth data comprises in train of four stimulation data or the train of four stimulation data ballism reaction height data for the first time.
11. a depth of anesthesia method for supervising has used depth of anesthesia supervising device as claimed in claim 1, it is characterized in that: utilization outreaches monitoring of equipment and goes out brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data; Receive brain electricity bispectral index, noxious stimulation data, neuromuscular blockade depth data through described depth of anesthesia supervising device; And to brain electricity bispectral index, noxious stimulation data, the neuromuscular blockade depth data is analyzed and laterally contrast, confirms the generation reason of brain electricity bispectral index fluctuation; Control the administration of analgesic, muscle relaxants and downern then by described depth of anesthesia supervising device.
12. depth of anesthesia method for supervising as claimed in claim 11 is characterized in that may further comprise the steps:
⑴, obtain brain electricity bispectral index and noxious stimulation data, transfer to data reception module, obtain the neuromuscular blockade depth data, transfer to data reception module through the neuromuscular monitoring device through anesthesia monitor monitoring;
⑵, digital data receiver module comprise that brain electricity bispectral index is accepted submodule, the noxious stimulation data are accepted submodule, neuromuscular blockade depth data reception submodule; Be respectively applied for and receive brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data, transfer to data analysis module;
⑶, data analysis module comprise data brain electricity bispectral index analysis submodule, noxious stimulation data analysis submodule, neuromuscular blockade depth data analysis submodule; Three sub-module are to the brain that receives electric bispectral index, noxious stimulation data and the neuromuscular blockade depth data is analyzed and laterally contrast, confirm the generation reason of brain electricity bispectral index fluctuation, transfer to the control output module;
⑷, control output module comprise target control operator module, injection control submodule; Target control operator module is calculated target control administration parameter according to bispectral index fluctuation of brain electricity and reason thereof; Injection control submodule is controlled the dosage of analgesic, muscle relaxants and downern according to the administration parameter.
13. depth of anesthesia method for supervising as claimed in claim 12 is characterized in that:
Described injection control submodule promotes actuating device through control step motor and syringe and realizes the regulation and control to dosage; Motor and syringe promote actuating device one and have three covers; Form A, B, three passages of C respectively; What passage A carried is downern, and what channel B was carried is analgesic, and what channel C was carried is muscle relaxants;
Noxious stimulation data analysis submodule if the noxious stimulation data are lower than lower limit fault value, transfers data to target control operator module, calculates the analgesic dosage that needs reduction, reduces the dosage of analgesic through injection control submodule control channel B; If the noxious stimulation data are higher than upper limit fault value, transfer data to target control operator module, calculate the analgesic dosage that needs increase, increase the dosage of analgesic through injection control submodule control channel B;
The neuromuscular blockade depth data is analyzed submodule; If the neuromuscular blockade depth data is lower than lower limit fault value; Transfer data to target control operator module, calculate the muscle relaxants dosage that needs reduction, reduce the dosage of muscle relaxants through injection control submodule control channel C; If the neuromuscular blockade depth data is higher than upper limit fault value, transfer data to target control operator module, calculate the muscle relaxants dosage that needs increase, increase the dosage of muscle relaxants through injection control submodule control channel C;
Brain electricity bispectral index is analyzed submodule, if noxious stimulation data and neuromuscular blockade depth data all do not exceed preset bound fault value, brain electricity bispectral index is judged; If brain electricity bispectral index is lower than lower limit fault value, transfer data to target control operator module, calculate the downern dosage that needs reduction, reduce the dosage of downern through injection control submodule control channel A; If brain electricity bispectral index transfers data to target control operator module according to being higher than upper limit fault value, calculate the downern dosage that needs increase, increase the dosage of downern through injection control submodule control channel A.
14. like each described depth of anesthesia method for supervising of claim 11～13; It is characterized in that:, set up brain electricity bispectral index, noxious stimulation data and neuromuscular blockade depth data and corresponding administration parameter synchronization curve chart thereof through synchronous curve module.
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Inventor after: Mai Chaowei Inventor after: Zhong Dinghui Inventor after: Zhou Wenjun Inventor after: Liu Yu Inventor after: Mai Yulin Inventor after: Zhang Yuxiong Inventor after: Huang Wenjian Inventor before: Mai Chaowei Inventor before: Zhong Dinghui Inventor before: Zhou Wenjun Inventor before: Mai Yulin Inventor before: Wang Zhi Inventor before: Zhang Yuxiong Inventor before: Huang Wenjian |
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Application publication date: 20121128 |