背景：對無法自主訴說的危重病人來說，疼痛和痛覺監(jiān)測仍然是一個挑戰(zhàn)，因為臨床癥狀既不敏感也不特異?，F(xiàn)有的技術方法受到了各種限制。我們研究了基于腦電圖（EEG）尋找在有害刺激之前或與行為痛覺反應相吻合的相關因素。

方法：在這項回顧性研究中，我們分析了64名危重病人在吸痰前、吸痰時和吸痰后的額葉腦電圖記錄。我們研究了腦電功率帶在行為反應之前或與之一致的相關性(行為疼痛評分7)。我們應用ManneWhitney U檢驗來計算相應的P值。

結(jié)果：在強烈的行為反應之前，2.5-5赫茲頻段的歸一化功率較高(17.1%；P<0.001)，0.1-1.5赫茲頻段的歸一化功率較低(-10.5%；P=0.029)。干預后，強烈的行為反應與2.5-5赫茲頻段較高的歸一化腦電功率(16.6%；P=0.021)和較低的8-12赫茲頻段的歸一化腦電功率(-51.2%；P=0.037)相關。

結(jié)論：我們觀察到腦電頻段功率的相關性先于傷害性刺激的行為反應，并與之一致。根據(jù)以前的發(fā)現(xiàn)，一些功率帶可能與痛覺、喚醒或鎮(zhèn)靜效應的處理有關。與傷害性感覺和覺醒更密切相關的功率帶可用于改善對傷害性感覺的監(jiān)測，并優(yōu)化重癥監(jiān)護患者的鎮(zhèn)痛管理。

原始文獻來源：Viktor Bublitz, Carlo Jurth, Matthias Kreuzer, et al. Electroencephalogram-based prediction and detection of responsiveness to noxious stimulation in critical care patients: a retrospective single-centre analysis.[J]Br J Anae, doi: 10.1016/j.bja.2022.09.031.

英文原文：

Electroencephalogram-based prediction and detection of responsiveness to noxious stimulation in critical care patients: a retrospective single-centre analysis

Abstract

Background: Monitoring of pain and nociception in critical care patients unable to self-report pain remains a challenge, as clinical signs are neither sensitive nor specific. Available technical approaches are limited by various constraints. We investigated the electroencephalogram (EEG) for correlates that precede or coincide with behavioural nociceptive responses to noxious stimulation

Method: In this retrospective study, we analysed frontal EEG recordings of 64 critical care patients who were tracheally intubated and ventilated before, during, and after tracheal suctioning. We investigated EEG power bands for correlates preceding or coinciding with behavioural responses (Behavioural Pain Scale 7). We applied the ManneWhitney U-test to calculate corresponding P-values.

Results: Strong behavioural responses were preceded by higher normalised power in the 2.5e5 Hz band (+17.1%; P<0.001) and lower normalised power in the 0.1-1.5 Hz band (-10.5%; P=0.029). After the intervention, strong behavioural responses were associated with higher normalised EEG power in the 2.5-5 Hz band (+16.6%; P=0.021) and lower normalised power in the 8-12 Hz band (-51.2%; P=0.037)

Conclusion: We observed correlates in EEG band power that precede and coincide with behavioural responses to noxious stimulation. Based on previous findings, some of the power bands could be linked to processing of nociception, arousal, or sedation effects. The power bands more closely related to nociception and arousal could be used to improve monitoring of nociception and to optimise analgesic management in critical care patients