兒童麻醉中腦電圖監測

Electroencephalographic Monitoring in Pediatric Anesthesia

腦電圖（electroencephalography, EEG）監測已成為成人手術期間麻醉深度測的重要工具，並被建議用於調整麻醉深度及避免過量用藥。然而，兒童腦部發育階段性明顯，EEG圖形在不同年齡層呈現顯著差異，使其在兒童麻醉中的應用更具挑戰性。本文介紹EEG的基本原理、處理方式、與兒童年齡相關的EEG變化，並探討其在全身麻醉常用藥物中的臨床應用。透過即時EEG監測，臨床醫師能更準確地掌握小兒病人麻醉深度，降低術中低血壓、術中甦醒及術後清醒延遲等風險。本文並整理常見干擾源（artifact），提供實務應用指引，期望促進EEG於小兒麻醉之普及與精準化。

Electroencephalography (EEG) monitoring is widely used in adult anesthesia to guide hypnotic depth and minimize drug overuse. In pediatric anesthesia, however, the application of EEG is more complex due to age-dependent neurodevelopmental changes in EEG characteristics. This article reviews EEG fundamentals, both unprocessed (waveform-based) and processed parameters, including BIS, Narcotrend, and SedLine systems. Age-specific EEG patterns are described in detail, from preterm infants to adolescents, emphasizing the interpretation challenges and physiological relevance. Furthermore, the utility of EEG in sevoflurane and propofol-based pediatric anesthesia is discussed, highlighting its role in preventing intraoperative hypotension, awareness, and delayed emergence. Common EEG artifacts and their implications are also addressed. Through proper EEG interpretation and integration, anesthesiologists can optimize pediatric anesthesia management with increased precision and safety.