CN100453041C - Anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy - Google Patents
Anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy Download PDFInfo
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- CN100453041C CN100453041C CNB200510086672XA CN200510086672A CN100453041C CN 100453041 C CN100453041 C CN 100453041C CN B200510086672X A CNB200510086672X A CN B200510086672XA CN 200510086672 A CN200510086672 A CN 200510086672A CN 100453041 C CN100453041 C CN 100453041C
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Abstract
The invention relates to an anesthesia detector, which comprises a signal generator, a paster, and the receiving optical fiber and transmitting laser fiber on the paster, analyzing circuit, data collecting circuit, and data analyzing system. The invention uses sound induction NIRS method to test the oxygen density of brain to test the brain metabolism, with the advantages of sound induction potential method and near-infrared laser oxygen testing method. The invention has high response as 0.1s, low cost and simple structure. And improve can improve the anesthesia quality, to judge the anesthesia depth.
Description
Technical field
The present invention relates to a kind of anesthesia monitoring device, particularly a kind of anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy that passes through.
Background technology
Anesthesia (Anesthesia) is a part of swound that makes patient's whole machine body or body with medicine or non-medicine, to reach painless purpose, is the important leverage of carrying out medical operating.Depth of anesthesia is very important index in the surgical operation, is pursuing one's goal of anesthetist and bioengineer to effective monitoring of depth of anesthesia always.
In the general anesthesia operation, the incidence rate of knowing in patient's art is about 1%～2%, can cause the outpatients mental state unhappiness thus, and frightened operation produces distrust and relevant psychological inversion to the doctor.Therefore should guarantee that patient realizes is in the complete obiteration state, avoids knowing in the art; Simultaneously prevent that again anesthetics is excessive, be beneficial to early and revive, reduce medical expense and reduce complication.In decades recently, utilize spontaneous brain electricity (EEG) and evoked brain potential (EP) to obtain expert's attention as the foundation of monitoring depth of anesthesia, there is the method for some monitoring cerebral cortex and brain stem level of anesthesia to come out, as brain electricity bispectral index (Bispectralindex, BIS) and auditory evoked potential (auditory evoked potentials, AEP).But still have many weak points.
Brain electricity bispectral index analytic process (BIS) utilizes computer technology EEG signals to be carried out the automatic analysis of frequency characteristic and phase characteristic, comprehensively extract the index of a kind of easy sign brain electricity different frequency composition component and level of consciousness corresponding relation, i.e. the BIS value.As the BIS system of U.S. spacelab SPACELAB, under waking state, frequency is very fast, and BIS is near 100.As seen BIS can fine prediction anaesthetic metabolite clearance and the situation of reviving of anesthesia, it is the good index of monitoring sedation depth, also be one of simple and easy to do effective ways, the EEG signal that brain electricity bispectral index (BIS) is commonly used routine passes through the computer digit conversion processing, draw the relation of level of consciousness and different frequency composition Quantitative Monitoring, this is the source of BIS value.But that BIS reacts is tranquillization level (resting level), the performance that can not finely reflect the central nervous system to irritant reaction.BIS uses more extensive in anesthesia depth monitoring, but along with increasing of using, its weak point also displays gradually; (1) with anaesthetic very big dependency is arranged, but relevant with environmental stimuli not obvious, can not reflect the moving reaction of body in the art; (2) same patient has different numerical value with different anesthetics, or different patient also has different numerical value with same medicine; (3) BIS calculates with a large amount of clinical datas that contrast is done in the past, easily causes error; (4) for brand-new anesthetics, its accuracy still has query; (5) computational speed of BIS is slower, take longer, 30～60 seconds.
Auditory evoked potential (AEP) can reflect the depth of anesthesia of multiple anaesthetic, and can monitor in the art and know, but clinical analysis AEP ripple is very loaded down with trivial details and difficult, so adopt Auditory Evoked Potential Index (AEP index).The about 45s of AEP time-consuming, Auditory Evoked Potential Index AAI (the improvement processing type of AEPI) still needs 2～6s, WIPO discloses PCT/DK00/00623 (publication number the is WO01/74248A1) patent application of Denmark special A/S (DANMETER A/S) company, it mainly is to utilize patient's auditory evoked potential (AEP) that reaction is produced for a repetition sonic stimulation to repeat to extract AEP and extract Auditory Evoked Potential Index AAI with rapid extraction method and superposed average method in conjunction with its exclusive autoregression model, make depth of anesthesia become 0～100 monitoring index, thereby distinguish patient's clear-headed and narcotism intuitively, but this monitoring method is because the AEP signal is very weak, signal to noise ratio is extremely low, cause the poor stability of monitor system, a little less than the capacity of resisting disturbance, requirement to working environment is very high, performance is unstable in general surgical environments, monitoring effect is not good, influences it and applies.Be the analysis-by-synthesis object with transient state AEP index in the particularly this method, its index that calculates is disturbed easily and false index occurred, influences the judgement of anaesthetist to depth of anesthesia.But, BIS can not monitor well from consciousness and disappear to clear-headed transition period variation, be not so good as heart rate variability index HRV aspect the reliability of reflection sedation depth, and BIS is invalid to some liquor-saturated medicine, and be subject to influences such as myoelectricity and working environment, disturb shortcomings such as individual variation is bigger.
BIS can only monitor the brain electricity inhibition that anaesthetic causes, and can not reflect the variation of wakefulness, i.e. the measurable anesthesia of BIS back consciousness recovery, anaesthetic are removed situation and analgesia level.AEP index then can better monitor from consciousness and disappear to the clear-headed transition period, can better predict the cognition reaction of patient to stimulating.But two kinds of methods can or be anaesthetized because of low temperature and are difficult to monitoring when reducing metabolism.Experiment is pointed out: BIS and AAI all can not effectively predict cardiovascular response and the moving generation of body during the general anesthesia induction tracheal intubation.BIS and AEP index reflect that in induction of anesthesia phase and art the depth of anesthesia situation is responsive, sensitivity and specificity at recovery from anesthesia phase reflection Consciousness then remain further to be improved, although it is that the monitoring on basis is highly sensitive but specificity is not strong that EEG is pointed out in experiment, cause to discern because the brain disorder that permanent damage produces.
Therefore, up to the present, also do not have a kind of reliable, continuously and the integrated approach of Quantitative Monitoring depth of anesthesia.
Summary of the invention
(1) technical problem that will solve
The objective of the invention is to overcome above-mentioned deficiency of the prior art, provide a kind of and adopt audition to induce the NIRS method to survey the anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy that brain oxygen density reaches deep measurement brain cortex metabolism purpose, integrates auditory evoked potential method and near-infrared laser brain oximetry advantage.
(2) technical scheme
For achieving the above object, the present invention adopts following technical scheme:
Anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy of the present invention, comprising:
Be used to produce the stimulus signal generation source that tuning note signal stimulus patient to be measured detects ear;
Place the paster of patient's forehead to be measured and place the reception optical fiber on the paster and transmit laser fiber, both sides otalgia to be measured is respectively placed one group and is listened district's optical fiber gauge head 4 as what brainstem auditory evoked detected usefulness;
The FPGA and the DSP modular system of doing algorithm process that are used for the control system flow process; ,
Obtaining the D/A change-over circuit of different analogue signals, and the acceptance probe that carries out signal sampling, the reception bandwidth-limited circuit that the waveform that receives is put in order;
The multi-path laser discharger of emission laser, and Laser Driven APC circuit arrangement, the transmission bandwidth-limited circuit that the waveform that sends is put in order;
Keyboard interface, a plurality of variable connectors and be used to show, print signal waveform and the display screen of each status signal of system and the USB interface that is used to connect a plurality of ports.
(3) beneficial effect
Advantage and good effect that the present invention has are, the present invention adopts audition to induce the NIRS method to reach deep measurement brain cortex metabolism purpose to survey brain oxygen density, advantage with auditory evoked potential method and near-infrared laser brain oximetry has than tradition anesthesia monitoring method and more to many advantage.Audition induces NIRS method advantage to be reliably to know in the sensitivity monitoring art, also has the fast characteristics of response, can reach 0.1s, than the fast 1-2 of an AEPI order of magnitude, and also simple in structure, cost is low, and than BIS, the AEP method more has price advantage.Also can avoid only energy measurement scalp position EEG signals of AEP method simultaneously, handle complicatedly, be subject to interferential problem, thereby not resemble electroencephalogram because of being lowered the temperature or anesthetics influences and presents the ischemia sample and change.
Description of drawings
The structural representation that Fig. 1 is to use device of the present invention that patient to be measured is monitored;
Fig. 2 is a circuit block diagram of the present invention.
The specific embodiment
For further understanding summary of the invention of the present invention, characteristics and effect, describe the specific embodiment of the present invention in detail below in conjunction with accompanying drawing.
With reference to Fig. 1, the structural representation that Fig. 1 is to use device of the present invention that patient to be measured is monitored.Adopt 780nm and two kinds of wavelength semiconductor laser of 808nm and high sensitivity photodiode.Place patient head to be measured measuring position to measure by optical fiber.Be provided with three groups altogether, every group with two different wave length semiconductor lasers.Two-way laser will be with two kinds of frequency modulation(PFM)s, so that can distinguish during signal processing.
The gauge head forehead is placed one group, is attached at the transmission laser fiber 2 of forehead and receives optical fiber 3 by paster 1, uses as comparison; Both sides otalgia to be measured is respectively placed one group and is listened district's optical fiber gauge head 4, detects as brainstem auditory evoked and uses.Because signal is extremely faint, adopts the DSP digital processing, and can show curve and data by liquid crystal display screen.What the auditory stimulus module that connects FPGA provided audition brings out signal to two in ear.
Fig. 2 is a circuit block diagram of the present invention.Whole device comprises as lower module: FPGA, and DSP, parallel D/A change-over circuit, parallel A/D change-over circuit, bandpass filtering, the auditory stimulus module, keyboard interface, display interface, USB interface, the download configuration interface, FLASH, variable connector and power supply etc., wherein:
(1) FPGA is the main flow process control of system, and DSP does algorithm process;
(2) parallel D/A change-over circuit can obtain 2 different frequencies and amplitude, phase place, all adjustable analogue signal of direct current biasing, parallel A/D change-over circuit can be sampled simultaneously to 2 analogue signals of single probe, send bandwidth-limited circuit waveform is carried out smoothly, receive bandwidth-limited circuit and take out the signal of required frequency;
(3) keyboard interface can be accepted user's control, and display module connects LCDs, can the shows signal waveform and signal such as each state of system;
(4) USB interface can be data upload to host computer, and the download configuration interface can online downloads DSP and FPGA code, FLASH preservation dsp operation code;
(5) two variable connectors can timesharing be controlled 3 groups of transmission probes and 3 group of received probe, and power module becomes the various voltages that system needs to 220V.
Wherein USB interface is optional module.
Among the present invention, can adopt the FPGA-based Tsunami PCI processor that is applicable to the high-performance calculation solution of TS-PCI-2501 model; DSP can adopt the TMS320C5000 serial model No. chip in the dsp chip.
The present invention adopts audition to induce the NIRS method to reach deep measurement brain cortex metabolism purpose to survey brain oxygen density, has the advantage of auditory evoked potential method and near-infrared laser brain oximetry, has than tradition anesthesia monitoring method and more manys advantage.Audition induces NIRS method advantage to be reliably to know in the sensitivity monitoring art, also has the fast characteristics of response, can reach 0.1s, than the fast 1-2 of an AEPI order of magnitude, and also simple in structure, cost is low, and than BIS, the AEP method more has price advantage.Also can avoid only energy measurement scalp position EEG signals of AEP method simultaneously, handle complicatedly, be subject to interferential problem, thereby not resemble electroencephalogram because of being lowered the temperature or anesthetics influences and presents the ischemia sample and change.
Adopt audition to induce NIRS method monitoring depth of anesthesia that potential high risk patient is helped greatly, the anesthesia quality can be greatly improved, can help the Anesthetist accurately to judge depth of anesthesia, even describe depth of anesthesia, satisfy and improve this growing requirement of anesthesia quality with numeral.Because people also can further make to the requirement of anesthesia quality more and more higher to the raising of self health requirements.From the total all types hospital of China 1.7 ten thousand these backgrounds of family, the social benefit of the existing raising anesthesia of the research of novel anesthesia depth monitoring method quality also has the market prospect that can expect.
More than be preferred forms of the present invention, according to content disclosed by the invention, some identical, replacement schemes that those of ordinary skill in the art can expect apparently all should fall into the scope of protection of the invention.
Claims (5)
1. anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy comprises:
Be used to produce the stimulus signal generation source that tuning note signal stimulus patient to be measured detects ear;
Place the paster of patient's forehead to be measured and place the reception optical fiber on the paster and transmit laser fiber, both sides otalgia to be measured is respectively placed one group and is listened district's optical fiber gauge head as what brainstem auditory evoked detected usefulness;
The FPGA and the DSP modular system of doing algorithm process that are used for the control system flow process;
Obtaining the D/A change-over circuit of different analogue signals, and the receiving transducer that carries out signal sampling, the reception bandwidth-limited circuit that the waveform that receives is put in order;
The multi-path laser discharger of emission laser, and Laser Driven APC circuit arrangement, the transmission bandwidth-limited circuit that the waveform that sends is put in order;
Keyboard interface, a plurality of variable connectors and be used to show, print signal waveform and the display screen of each status signal of system and the USB interface that is used to connect a plurality of ports.
2. anesthesia depth monitor as claimed in claim 1, wherein said laser beam emitting device adopts the semiconductor laser and the high sensitivity photodiode of 780nm and two kinds of wavelength of 808nm.
3. anesthesia depth monitor as claimed in claim 1 is wherein wanted two kinds of frequency modulation(PFM)s to described laser beam emitting device emitted laser so that can distinguish when making signal processing.
4. to host computer, the download configuration interface can online downloads DSP and FPGA code, FLASH preservation dsp operation code data upload for anesthesia depth monitor as claimed in claim 1, wherein said USB interface.
5. as each described anesthesia depth monitor of claim 1-4, wherein said USB interface is selectable module.
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| CNB200510086672XA CN100453041C (en) | 2005-10-20 | 2005-10-20 | Anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy |
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| CNB200510086672XA CN100453041C (en) | 2005-10-20 | 2005-10-20 | Anesthesia depth monitor utilizing auditory stimulation and near infrared spectroscopy |
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| CN100453041C true CN100453041C (en) | 2009-01-21 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9849241B2 (en) | 2013-04-24 | 2017-12-26 | Fresenius Kabi Deutschland Gmbh | Method of operating a control device for controlling an infusion device |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8155736B2 (en) * | 2009-03-16 | 2012-04-10 | Neurosky, Inc. | EEG control of devices using sensory evoked potentials |
| CN102232833B (en) * | 2011-07-22 | 2013-05-08 | 华南理工大学 | Audiometry device based on over-sampled multi-frequency multi-amplitude joint estimated auditory evoke potentials |
| CN109431464B (en) * | 2018-10-25 | 2021-05-18 | 惠良图 | Multifunctional anesthesia depth monitoring device for anesthesia department |
| CN113951901B (en) * | 2021-11-19 | 2024-03-01 | 中国中医科学院西苑医院 | Automatic analysis system and method for data acquisition effectiveness of electroencephalogram |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| US9849241B2 (en) | 2013-04-24 | 2017-12-26 | Fresenius Kabi Deutschland Gmbh | Method of operating a control device for controlling an infusion device |
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