上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (2): 271-.doi: 10.3969/j.issn.1674-8115.2020.02.022

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全身麻醉术中伤害性刺激监测的研究进展

陈黎明，于布为   

  1. 上海交通大学医学院附属瑞金医院麻醉科，上海 200025
  • 出版日期:2020-02-28 发布日期:2020-03-20
  • 通讯作者: 于布为，电子信箱：yubuwei_2013@126.com。
  • 作者简介:陈黎明（1994—），女，住院医师，硕士生；电子信箱：982777383@qq.com。

Development of objective assessment of nociception during general anesthesia

CHEN Li-ming, YU Bu-wei   

  1. Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2020-02-28 Published:2020-03-20

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摘要： 全身麻醉术中疼痛的诊断与治疗依赖于伤害性刺激监测。在过去的数十年中，伤害性刺激监测方法的研究主要集中在自主神经系统变化监测及脑电监测。其中，监测自主神经系统变化的指标主要包括镇痛与伤害性刺激指数、皮肤导电性、外科容积指数、瞳孔直径。该文主要介绍目前伤害性刺激监测方法的发展和应用情况。这些监测方法有各自的优势及不足，但尚无一个理想的伤害性刺激监测方法可以推荐应用于临床。

关键词: 伤害性刺激监测, 镇痛与伤害性刺激指数, 皮肤导电性, 外科容积指数, 瞳孔直径, 脑电监测

Abstract:

Pain diagnosis and management benefit the development of objective assessment of nociception during general anesthesia. In the past decades, research addressing this issue has focused on monitoring changes in the autonomic nervous system and monitoring electroencephalograph. The indicators for monitoring changes in the autonomic nervous system include analgesia nociception index, skin conductance, surgical pleth index and pupil diameter. This article introduces the most important developments and usages of current monitoring methods for noxious stimulation, which have their own advantages and disadvantages. There are currently no validated objective assessment of nociception that can be recommended for clinical use.

Key words: objective assessment of nociception, analgesia nociception index (ANI), skin conductance (SC), surgical pleth index (SPI), pupil diameter (PD), electroencephalograph monitoring