NEW METHOD OF NEUROPHISIOLOGICAL MONITORING OF SOME ANESTHESIOLOGIC COMPONENTS.

Adequate anesthesia monitoring till this time was connected with evaluation of electrophysiologic indexes from the native EEG computer adaptation (SEF 80-90%, BIS, AEP). Unfortunately no one of these methods is wide spread now because of the different objective difficulties. Obviously evaluation of the adequate anesthesia using only one parameter doesn't reflect all many-sided alterations which are observing during anesthesia. Today is clear that the application of the EEG methods reflects only deepness of the conscience depression because for the control of the myorelaxation etlectromiografic dates are used, but for evaluation of the vegetative status - spectral cardiointervalography. At same time another obligate components of the anesthesiologic benefits (psycho-emotional comfort (PEC) and analgesia) which have the biggest value during different variants of regional blockades especially long one are based on the subjective evaluation. From the other side the possibilities of using skin-galvanic resist (SGR) for the detecting of the these indexes efficiency were very well known, but were ignored till this time because of the difficulties of electric skin resist registration in the on line regime and impossibility of the SGR visualization after using of some anesthetics, particularly atropine. Computer program which was created by JSC "Neurocom" gives an opportunity not only to record SGR, but to control human conscience using SGR index (SGRI). Such an approach was successfully used in the similar situations for the control of human conscience during professional stresses (to provide safety of the long train or auto trips). The experience of using this method during surgical operations under the squared anesthesia on the base of regional blockades allowed not only use it as additional parameter for the determination of the human conscience level (with SRF 90%), but create principals of the psycho-emotional condition monitoring after the operation. Herewith, psycho-emotional discomfort index (PEDI) was developed for the more precise determination of the psycho-emotional constraint of the patient during regional anesthesia. At same time positional discomfort (PD) was determined to be the main component of the psycho-emotional disorders during long time regional anesthesia. PD is manifested with increasing discomfort, pain out of operation region and uncontrolled motional activity.

Connection PD with pain reaction allows to adapt method PEDI also for determination of the analgesic component efficiency including different variants of general anesthesia. Herewith, PEDI is characterized not only by high information level, but provides an opportunity for advance of operation trauma hemodynamic reactions. So application of the SGR allows to evaluate the psycho-emotional condition of the patient in the on line regime either during regional anesthesia sedation or during different variants of general anesthesia (including uncontrolled interoperation waking up). SGR can be used as additional reliable method of the patient continence evaluation, when EEG methods do not work.

 

 

 

 

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