目的:探讨老年手术患者椎管内麻醉后应用异丙酚镇静,脑电双频指数、异丙酚血药浓度和镇静深度之间的相关性［1］。方法:48例ASAⅠ~Ⅱ级择期手术患者,分为老年组(65~85岁)和年轻组(18~40岁),每组24例。为尽快达到稳态血药浓度,采用靶控输注方式给药。异丙酚靶浓度从0.5 μg/mL起逐渐增加,直至患者对轻推无反应(意识消失),每个浓度维持5min。连续记录EEG参数,在每一稳态血药浓度末,记录BIS、95%SEF, 桡动脉取血(高效液相色谱法测定异丙酚血药浓度),并评定镇静深度(OAA/S评分法)。用Spearman’s等级相关进行相关分析,并计算预测概率 (Pk) 值。结果:两组BIS (r=0.935~0.955) 与镇静水平的相关性优于血药浓度(r =0.849~0.870)和95%SEF(r =0.503~0.571),BIS的Pk值高(0.942~0.972)。在同一镇静评分(OAA/S 4~1)时,老年组BIS值明显高于年轻组(Plt;0.01),而血药浓度低于年轻组(Pgt;0.05)。结论:BIS在监测异丙酚镇静水平及预测意识消失方面有重要价值,在同一镇静评分时,老年人BIS值高于年轻人。
Cognitive enhancement refers to the technology of enhancing or expanding the cognitive and emotional abilities of people without psychosis based on relevant knowledge of neurobiology. The common methods of cognitive enhancement include transcranial direct current stimulation (tDCS) and cognitive training (CT). tDCS takes effect quickly, with a short effective time, while CT takes longer to work, requiring several weeks of training, with a longer effective time. In recent years, some researchers have begun to use the method of tDCS combined with CT to regulate the cognitive function. This paper will sort out and summarize this topic from five aspects: perception, attention, working memory, decision-making and other cognitive abilities. Finally, the application prospect and challenges of technology are prospected.