ERAS之精準麻醉深度監控

Monitoring the Depth of Anesthesia

台灣每年有近百萬人次接受麻醉，然而要達到高品質的麻醉照護，需要麻醉深度監測，將藥物對全身器官的影響降到最低，加速病人甦醒及早期恢復。麻醉深度太淺，病人容易在手術中甦醒；麻醉深度太深，會抑制心血管系統，影響術後意識變化、延遲恢復、增加譫妄發生，並且延長住院天數、增加死亡率。因此，如何達到適合的麻醉深度，是目前術後加速康復療程（enhanced recovery after surgery, ERAS）的目標之一。監測麻醉深度，不僅能預防術中甦醒，將麻醉藥物的用量降到最低需求，以降低併發症，尤其對於年長者認知功能障礙之預防有極為明顯之差異。因此，藉由麻醉深度監測儀的使用，讓手術病患達到適當的麻醉深度，減少麻醉相關的併發症，促進病患術後恢復，是ERAS的非常重要一環。 In Taiwan, nearly millions of people underwent anesthesia every year. However, depth of anesthesia monitoring is required to minimize the impact of anesthetic agents on the whole body, facilitate rapid awakening from anesthesia, and therefore, accelerate postoperative recovery and thus improves quality of anesthesia care. Unintended intraoperative awareness appears when light level of anesthesia is practiced. Too deep anesthesia will inhibit the cardiovascular system, affect postoperative cognitive function, delayed recovery and occurrence of delirium and eventually prolongs length of hospital stay and increases postoperative mortality. Therefore, how to achieve a suitable depth of anesthesia is one of the goals of ERAS (enhanced recovery after surgery). Monitoring the depth of anesthesia can not only prevent intraoperative awareness, but also reduce the amount of anesthetic drugs to a minimum to reduce complications, especially for elderly people with cognitive dysfunction. In conclusion, using depth of anaesthesia monitoring to allow the surgical patient to reach an appropriate depth of anesthesia, reduce anesthesia-related complications, and facilitate early postoperative recovery is a very important part of ERAS.