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1.
IntroductionThe use of alveolar recruitment maneuvers during general anaesthesia of horses is a potentially useful therapeutic option for the ventilatory management. While the routine application of recruitments would benefit from the availability of dedicated large animal ventilators their impact on ventilation and perfusion in the horse is not yet well documented nor completely understood.Case historyA healthy 533 kg experimental horse underwent general anaesthesia in lateral recumbency. During intermittent positive pressure ventilation a stepwise alveolar recruitment maneuver was performed.ManagementAnaesthesia was induced with ketamine and midazolam and maintained with isoflurane in oxygen using a large animal circle system. Mechanical ventilation was applied in pressure ventilation mode and an alveolar recruitment maneuver performed employing a sequence of ascending and descending positive end expiratory pressures. Next to the standard monitoring, which included spirometry, additionally three non-invasive monitoring techniques were used: electrical impedance tomography (EIT), volumetric capnography and respiratory ultrasonic plethysmography. The functional images continuously delivered by EIT initially showed markedly reduced ventilation in the dependent lung and allowed on-line monitoring of the dynamic changes in the distribution of ventilation during the recruitment maneuver. Furthermore, continuous monitoring of compliance, dead space fraction, tidal volumes and changes in end expiratory lung volume were possible without technical difficulties.Follow upThe horse made an unremarkable recovery.ConclusionThe novel non-invasive monitoring technologies used in this study provided unprecedented insights into the physiology of lung collapse and recruitment. The synergic information of these techniques holds promise to be useful when developing and evaluating new ventilatory strategies in horses.  相似文献   

2.
Experiences with a new technique of closed circuit anaesthesia used for 1003 surgical cases involving cats and dogs are described. The technique utilises the combined vapors of methoxyflurane and halothane from dual, low-resistance vaporisers situated in series, and supported by low flow rates of 100% oxygen in the inspiratory limb of the anaesthetic machine. This anaesthetic circuit can be adapted for many surgical procedures involving both controlled and spontaneous ventilation techniques and for young and old animals. The technique is considered safe, economical and easily managed and pollution of the operating theatre is eliminated by the use of the completely closed circuit.  相似文献   

3.
Reasons for performing study: To determine the sedative, analgesic and anaesthetic drugs and techniques that are used by equine veterinarians. Hypothesis or objectives: To provide equine veterinarians with information concerning veterinary use of anaesthetic techniques, a reflection of the collective experiences of the profession. Methods: A survey was conducted of those members of the American Association of Equine Practitioners (AAEP) with an electronic mail address on file with the organisation using proprietary, web‐based software. The survey was comprised of 30 questions divided into 8 sections: nonsteroidal anti‐inflammatory drugs; local anaesthesia; alternative techniques; standing chemical restraint; epidural anaesthesia; short‐term anaesthesia; long‐term anaesthesia; and a place for the respondent to make comments. Results: The response rate was 13.8% (952/6911) AAEP member veterinarians primarily use phenylbutazone and flunixin as anti‐inflammatory drugs, and lidocaine and mepivacaine for local anaesthesia. Combinations of drugs are preferred for standing chemical restraint. While many veterinarians frequently utilise short‐term anaesthesia, longer anaesthesia is less frequently performed. Conclusions: Most AAEP member veterinarians use sedatives in combination to provide standing chemical restraint. Extra‐label use of drugs is a core component of current equine sedation and anaesthetic practice. Potential relevance: Equine veterinarians can compare their choices of anaesthetic drugs with others practising equine medicine and surgery and may be stimulated to investigate alternative methods of providing comfort to horses.  相似文献   

4.
In the first edition of this journal, Barbara Weaver wrote a review titled ‘Equine Anaesthesia’, stating that, at that time, it was quickly becoming accepted practice that many horses were being anaesthetised ‘by essentially similar procedures, i.e. premedication, induction and then maintenance by controlled inhalation’. To celebrate the 50th anniversary of the first edition of this journal, this review covers the development of understanding and practice of inhalational anaesthesia and controlled ventilation in horses over the last 50 years. We review how the perceived benefits of halothane led to its widespread use, but subsequently better understanding of halothane's effects led to changes in equine anaesthetic practice and the utilisation of different inhalation agents (e.g. isoflurane and sevoflurane). We discuss how more recently, better understanding of the effects of the ‘newer’ inhalation agents’ effects has led to yet more changes in equine anaesthetic practice, and while, further new inhalation agents are unlikely to appear in the near future, further enhancements to anaesthetic practice may still lead to improved outcomes. We review advances in our understanding of the anatomy and pathophysiology of the equine lung as well of the effects of anaesthesia on lung function and how these predispose to some of the common problems of gas exchange and ventilation during anaesthesia. We identify the aims of optimal mechanical ventilation for anaesthetic management and whether the various methods of ventilatory support during equine anaesthesia achieve them. We also highlight that further developments in equipment and optimal ventilator modes are likely in the near future.  相似文献   

5.
Objective  To remodel and validate commercially available monitors and their Pitot tube-based flow sensors for use in large animals, using in vitro techniques.
Study design  Prospective, in vitro experiment.
Methods  Both the original and the remodelled sensor were studied with a reference flow generator. Measurements were taken of the static flow-pressure relationship and linearity of the flow signal. Sensor airway resistance was calculated. Following recalibration of the host monitor, volumes ranging from 1 to 7 L were generated by a calibration syringe, and bias and precision of spirometric volume was determined. Where manual recalibration was not available, a conversion factor for volume measurement was determined. The influence of gas composition mixture and peak flow on the conversion factor was studied.
Results  Both the original and the remodelled sensor showed similar static flow–pressure relationships and linearity of the flow signal. Mean bias (%) of displayed values compared with the reference volume of 3, 5 and 7 L varied between −0.4% and +2.4%, and this was significantly smaller than that for 1 L (4.8% to +5.0%). Conversion factors for 3, 5 and 7 L were very similar (mean 6.00 ± 0.2, range 5.91–6.06) and were not significantly influenced by the gas mixture used. Increasing peak flow caused a small decrease in the conversion factor. Volume measurement error and conversion factors for inspiration and expiration were close to identity.
Conclusion  The combination of the host monitor with the remodelled flow sensor allowed accurate in vitro measurement of flows and volumes in a range expected during large animal anaesthesia.
Clinical relevance  This combination has potential as a reliable spirometric monitor for use during large animal anaesthesia.  相似文献   

6.
Reasons for performing study: Dexmedetomidine has been administered in the equine as a constant‐rate infusion (CRI) during inhalation anaesthesia, preserving optimal cardiopulmonary function with calm and coordinated recoveries. Inhalant anaesthetic sparing effects have been demonstrated in other species, but not in horses. Objectives: To determine the effects of a CRI of dexmedetomidine on the minimal alveolar concentration (MAC) of sevoflurane in ponies. Methods: Six healthy adult ponies were involved in this prospective, randomised, crossover, blinded, experimental study. Each pony was anaesthetised twice (3 weeks washout period). After induction with sevoflurane in oxygen (via nasotracheal tube), the ponies were positioned on a surgical table (T0), and anaesthesia was maintained with sevoflurane (expired sevoflurane fraction 2.5%) in 55% oxygen. The ponies were randomly allocated to treatment D (dexmedetomidine 3.5 µg/kg bwt i.v. [T10–T15] followed by a CRI of dexmedetomidine at 1.75 µg/kg bwt/h) or treatment S (bolus and CRI of saline at the same volume and rate as treatment D). After T60, MAC determination, using a classic bracketing technique, was initiated. Stimuli consisted of constant‐current electrical stimuli at the skin of the lateral pastern region. Triplicate MAC estimations were obtained and averaged in each pony. Monitoring included pulse oximetry, electrocardiography, anaesthetic gas monitoring, arterial blood pressure measurement and arterial blood gases. Normocapnia was maintained by mechanical ventilation. Analysis of variance (treatment and period as fixed factors) was used to detect differences between treatments (α= 0.05). Results: An intravenous (i.v.) dexmedetomidine CRI decreased mean ± s.d. sevoflurane MAC from 2.42 ± 0.55 to 1.07 ± 0.21% (mean MAC reduction 53 ± 15%). Conclusions and potential relevance: A dexmedetomidine CRI at the reported dose significantly reduces the MAC of sevoflurane.  相似文献   

7.
The pressure flow characteristics of a demand valve which has been suggested to be suitable for use in anaesthetised horses were determined at a range of flow rates commonly encountered in equine anaesthesia. The resistance of the valve was found to be very much greater than the resistance of normal large animal anaesthetic apparatus or the equine lower respiratory tract. The effects of the valve on pulmonary ventilation were investigated in seven anaesthetised, intubated horses. Respiratory rate and dynamic compliance were unaffected by connection of the valve but mean tidal and minute volumes and peak flow rates were substantially reduced. The change in transpulmonary pressure over the respiratory cycle was doubled and indices of work of breathing increased by a factor of three. It was concluded that the resistance offered by the valve was too great for its use in spontaneously breathing horses to be recommended.  相似文献   

8.

Objective

To compare the effects of two concentrations of oxygen delivered to the anaesthetic breathing circuit on oxygenation in mechanically ventilated horses anaesthetised with isoflurane and positioned in dorsal or lateral recumbency.

Methods

Selected respiratory parameters and blood lactate were measured and oxygenation indices calculated, before and during general anaesthesia, in 24 laterally or dorsally recumbent horses. Horses were randomly assigned to receive 100% or 60% oxygen during anaesthesia. All horses were anaesthetised using the same protocol and intermittent positive pressure ventilation (IPPV) was commenced immediately following anaesthetic induction and endotracheal intubation. Arterial blood gas analysis was performed and oxygenation indices calculated before premedication, immediately after induction, at 10 and 45 min after the commencement of mechanical ventilation, and in recovery.

Results

During anaesthesia, the arterial partial pressure of oxygen was adequate in all horses, regardless of position of recumbency or the concentration of oxygen provided. At 10 and 45 min after commencing IPPV, the arterial partial pressure of oxygen was lower in horses in dorsal recumbency compared with those in lateral recumbency, irrespective of the concentration of oxygen supplied. Based on oxygenation indices, pulmonary function during general anaesthesia in horses placed in dorsal recumbency was more compromised than in horses in lateral recumbency, irrespective of the concentration of oxygen provided.

Conclusion

During general anaesthesia, using oxygen at a concentration of 60% instead of 100% maintains adequate arterial oxygenation in horses in dorsal or lateral recumbency. However, it will not reduce pulmonary function abnormalities induced by anaesthesia and recumbency.  相似文献   

9.
The aim of the present study was to compare the safety of two low flow (LF) regimes [fresh gas flow (FGF) 20 ml/kg/min (group 2) and 14 ml/kg/min (group 3)] with the high flow (HF) technique (FGF 50 ml/kg/min; group 1) of isoflurane anaesthesia. Data were gathered from ninety dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs had an anaesthetic induction with 0,6 mg/kg I-methadone (maximum 25 mg) and 1 mg/kg diazepam (maximum 25 mg) i.v. Anaesthesia was maintained with isoflurane in a mixture of 50% O2 and 50% N2O as carrier gases, with controlled ventilation. The Monitoring included electrocardiogramm, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane). The consumption of isoflurane and carrier gases as well as the recovery times were evaluated for the three groups. The inspired oxygen concentrations always ranged above the minimum value of 30 Vol.-% during low flow anaesthesia. The arterial oxygen saturation ranged between 92-98%, the end tidal concentration of CO2 between 35 and 45 mmHg. Heart rate and arterial blood pressure were within normal limits. Recovery time was significantly shorter after LF than after HF anaesthesia. The highest decrease in body temperature occurred in the HF group 1 because of a significantly lower anaesthetic gas temperature. Despite this, LF anaesthesia resulted in a reduced consumption of carrier gases and volatiles. In conclusion, low flow anaesthesia with isoflurane is a safe technique and offers substantial economic advantages over high flow techniques and is moreover better tolerated by the patients.  相似文献   

10.
Endotracheal intubation is an essential component of general anaesthesia in horses to facilitate delivery of inhalation anaesthetic agent and oxygen, artificial ventilation, and prevent pulmonary aspiration of blood or gastric reflux. Experimental studies have identified a high incidence of tracheal mucosal injury after intubation resulting from direct trauma or local ischaemia from the pressure of the inflated cuff. Recommendations to minimise injury include gentle intubation, disconnection from the anaesthesia machine when moving the horse, and monitoring the endotracheal tube cuff pressure. New studies are needed to evaluate trachea and cuff pressure interactions under current practice conditions, including specialised ventilation modalities such as positive end‐expiratory pressure and continuous airway pressure.  相似文献   

11.
OBJECTIVE: To quantify the isoflurane measurement error arising from the use of short wavelength infrared (IR) anaesthetic gas analysis during low flow anaesthesia in horses. STUDY DESIGN: Prospective clinical study. ANIMAL POPULATION: Sixty-four client-owned horses referred for elective or emergency surgery (age 1-16 years, body mass 400-650 kg). MATERIALS AND METHODS: Horses were divided into four groups based on duration of pre-anaesthetic food deprivation period (FDP) and fresh gas flow during anaesthesia: a high flow group with normal FDP (n = 16) and three groups with low flow and normal (n = 29), long (n = 5) or no (n = 14) FDP, respectively. Circuit isoflurane concentrations were measured simultaneously using a short wavelength (methane-sensitive) analyser (Datex Capnomac Ultima) and a long wavelength (methane-insensitive) analyser (Hewlett Packard M 1025 B) for at least 60 minutes. The difference between the readings of both analysers gave the isoflurane measurement error of short wavelength IR analysis, from which the circuit methane concentration was calculated. RESULTS: In the low flow groups, isoflurane measurement error increased over time, whereas in the high flow group, error remained constant after an initial rise in the first 15 minutes. The isoflurane measurement error was significantly lower (p < 0.005) in the high flow group compared with the low flow-normal FDP group from 15 to 60 minutes. Compared to the low flow - normal FDP group, isoflurane measurement error was significantly smaller (p < 0.001, from 15 to 60 minutes) in the low flow-long FDP group and significantly larger (p = 0.016, at 60 minutes) in the low flow-no FDP group. Within the low flow-no FDP group, values in colic cases did not differ from those in noncolic cases (p > 0.7). CONCLUSIONS: Isoflurane measurement using short wavelength IR absorption is inaccurate. The fresh gas flow and duration of pre-anaesthetic food deprivation influence the isoflurane measurement error during anaesthesia in horses. CLINICAL RELEVANCE: Short wavelength IR analysers are not reliable for isoflurane measurement during (low flow) anaesthesia in horses.  相似文献   

12.
Objective To determine whether predictable alveolar concentrations of sevoflurane are reliably produced in dogs when liquid sevoflurane is injected into closed circuit breathing systems, as calculated by Lowe's square‐root‐of‐time anaesthetic uptake model, and to confirm the validity of the model using soda lime and calcium hydroxide lime. Study design Prospective clinical study. Animals Eleven healthy dogs with a mean body mass of 34 ± 9 kg scheduled for pelvic limb orthopaedic surgery. Materials and methods Following pre‐anaesthetic medication, anaesthesia was induced with propofol and maintained with sevoflurane in a closed circle system. Epidural anaesthesia was performed with morphine and bupivacaine. Liquid sevoflurane was injected into the circuit by syringe, using dosages and time intervals derived from Lowe's square‐root‐of‐time anaesthetic uptake model. The target alveolar concentration chosen was 1.1 × MAC (2.6% end‐tidal sevoflurane). Either soda lime (group S; n = 6) or calcium hydroxide lime (Amsorb; group A; n = 5) were used for CO2 absorption. Sevoflurane concentration and the respiratory gas composition were measured with an infrared gas analyser. Results End‐tidal sevoflurane concentrations were close to the predicted value of 2.6% at 9 minutes (2.53 ± 0.1% group S; 2.60 ± 0.26% group A) and 16 minutes (2.55 ± 0.30 group S; 2.52 ± 0.28% group A) but declined thereafter to reach 50% (group S) and 64% (group A) of the predicted value at 121 minutes. There was a constant trend towards higher end‐tidal sevoflurane concentrations in group A but the difference was not statistically significant. Conclusions The square‐root‐of‐time model leads to significantly lower alveolar concentrations than expected, suggesting that the rate of sevoflurane uptake in dogs declines less rapidly than predicted. The use of Amsorb tends to reduce the deviation from predicted concentrations. Clinical relevance The model used in this study provided only an approximate guide to the volume of liquid sevoflurane required. Consequently, the definitive dose schedule must be based on measured anaesthetic concentrations and clinical monitoring.  相似文献   

13.
Objective The aim of this study was to define and evaluate a combined inhalation?intravenous anaesthetic protocol for use in equine anaesthesia. Study design Prospective, randomized clinical trial. Animals Twenty‐eight horses (body mass 522 ± 82; 330–700 kg [mean ± SD; range]) with a mean age of 6 ± 4 years (range: 2–18 years) presented to the university hospital for various surgical procedures requiring general anaesthesia. Materials and methods Animals were randomly allocated to one of two treatment groups. Anaesthesia was maintained in 14 horses with halothane alone (H group). The mean end‐tidal halothane concentration was 1.24%. In the second group (n = 14) anaesthesia was maintained with both halothane (end‐tidal concentration 0.61%) and a continuous infusion of a ketamine–guaiphenesin mixture (HKG group). The two techniques were compared in terms of qualitative differences and cardiopulmonary effects. Results The stability of anaesthesia was significantly greater in group HKG and the need for dobutamine to maintain blood pressure was significantly less. Recovery times and quality were acceptable in all cases. There were no significant differences between the groups. Conclusions The infusion of ketamine and guaiphenesin in horses receiving low inspired concentrations of halothane provides suitable surgical anaesthesia and lowers the risk of hypotension. Clinical relevance The anaesthetic technique described in this study is a useful and practical alternative to inhalation anaesthesia using halothane alone.  相似文献   

14.
The aim of the present study was to compare the safety and efficacy of sevoflurane and isoflurane during low flow anaesthesia (fresh gas flow (FGF) 14 ml/kg/min) as well as to compare the consumption of both anaesthetics. Data were gathered from 60 dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs were induced with 0.6 mg/kg (maximum 25 mg) l-methadone and 1 mg/kg (maximum 25 mg) diazepam i.v.. Anaesthesia was maintained with isoflurane (group 1) or sevoflurane (group 2) in a mixture with 50% O2 and 50% N2O as carrier gases, under controlled ventilation. Monitoring included electrocardiogram, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane, sevoflurane). The consumption of isoflurane and sevoflurane as well as the dogs' recovery times were evaluated for both groups. In all groups the inspired oxygen concentrations ranged above the minimum value of 30 Vol% during low flow anaesthesia, with an arterial oxygen saturation above 97%. End tidal concentration of CO2, heart rate and arterial blood pressure were within the physiological ranges and showed no differences between the two groups. Recovery time was significantly shorter after sevoflurane compared to isoflurane anaesthesia, whilst the consumption of sevoflurane was higher than that of isoflurane. Sevoflurane appears to be as clinically safe as isoflurane in low flow anaesthesia. Even considering that sevoflurane is more expensive than isoflurane, the use of the low flow technique decreases the cost of anaesthesia due to the reduced volatile anaesthetic consumption.  相似文献   

15.
The number of donkeys and mules throughout the world is stable, and awareness of their use and concern for welfare, pain recognition and treatment are receiving increasing veterinary interest. Therefore, accurate information about anaesthesia and analgesia in donkeys and mules is important to ever more equine practitioners. Since donkeys are physiologically and pharmacologically different from horses, knowledge on species specific aspects of anaesthesia and analgesia are very important. Mules combine elements from both donkey and horse backgrounds, leading to great diversity in size, temperament and body type. Physiologically, they seem to resemble horses more than donkeys. This review highlights the current knowledge on various anaesthetic and analgesic approaches in donkeys and mules. There is still much information that is not available about donkeys; in many circumstances, the clinician must use available equine information to treat the patient, while monitoring carefully to observe for differences in response to therapy compared to the horse.  相似文献   

16.
Monitoring the composition of gases breathed by anaesthetised patients requires measurement methods with fast responses, high accuracy and good reliability. There is also an increasing demand for systems to be able to monitor more than one target analyte simultaneously, but some gas analysers can be sensitive to the presence of methane gas in exhaled breath, consequently leading to inaccurate measurements of the anaesthetic agent. This study investigated the feasibility of employing portable quadrupole mass spectrometry to monitor volatile anaesthetic agents (halothane, isoflurane and sevoflurane), methane accumulation in anaesthetic rebreathing systems, and inspired and exhaled carbon dioxide and oxygen concentrations during equine anaesthesia in a clinical setting. The volatile anaesthetic agents were easily measurable and methane was detectable. The instrument had an advantage over short wavelength infrared absorption spectrometry analysers because it could monitor anaesthetic agents and other respiratory gases simultaneously and at extremely low concentrations, although further optimisation is required.  相似文献   

17.
ObjectiveWe describe and test a novel device for large animal anaesthesia monitoring that uses standard human medicine spirometry sensors.Study designIn-vitro study.MethodsThe device consists of two adapters that enable the flow to be split evenly into four tubes in parallel, each tube containing a D-lite sensor. The performance of this flow partitioning device (FPD) over a range of flows from 100 to 700 L minute?1 was determined and the pressure versus flow relation, resistance and dead space was compared with a Horse-lite (Moens 2010).ResultsEquipped with four D-lite sensors, and a flow of 700 L minute?1 the pressure drop of the FPD was 13.5 cmH2O, resistance 1.17 cmH2O second L?1 and volume (potential dead space) 182 mL, compared to 2.8 cmH2O, 0.24 cmH2O second L?1 and 54 mL respectively for the Horse-lite. The predicted value of the flow partition of ¼ could be confirmed. Limits of agreement were found to be 4.2% in inspiratory direction and 7.1% in expiratory direction.Conclusions and clinical relevanceThe FPD is an affordable device that extends the specification of any commercially available human spirometry sensors to large animal applications. However, an increase in total resistance and dead space has to be taken into account. Therefore, the new device could be useful during equine anaesthesia.  相似文献   

18.
Several new multi-purpose non-rebreathing anaesthetic systems have been developed for human anaesthesia. This study evaluated a New Zealand designed non-rebreathing circuit, the Palmerston Valve, in anaesthetised spontaneously breathing dogs and compared it to the widely used Lack coaxial circuit. Arterial blood gas measurements 60 minutes after induction demonstrated comparable slight increases in PaCO2 in nearly all dogs maintained on the Palmerston Valve and Lack coaxial circuit with halothane and oxygen mixtures, and a fresh gas flow rate of 70 ml/kg/min. Results suggest the Palmerston Valve is at least as efficient as the Lack coaxial circuit, while offering in the same unit the potential for economical controlled ventilation.  相似文献   

19.
Several new multi-purpose non-rebreathing anaesthetic systems have been developed for human anaesthesia. This study evaluated a New Zealand designed non-rebreathing circuit, the Palmerston Valve, in anaesthetised spontaneously breathing dogs and compared it to the widely used Lack coaxial circuit. Arterial blood gas measurements 60 minutes after induction demonstrated comparable slight increases in PaCO2 in nearly all dogs maintained on the Palmerston Valve and Lack coaxial circuit with halothane and oxygen mixtures, and a fresh gas flow rate of 70 ml/kg/min.

Results suggest the Palmerston Valve is at least as efficient as the Lack coaxial circuit, while offering in the same unit the potential for economical controlled ventilation.  相似文献   

20.
Depth of anaesthesia   总被引：1，自引：0，他引：1  
One hundred and fifty years after the first general anaesthetic in 1846 our knowledge about the mechanisms of general anaesthetics is still very sparse. The concept ‘depth of anaesthesia’ was introduced by John Snow (1847). He described ‘5° of narcotism’. Because one single agent had to provide all the components of general anaesthesia, the main problem for the anaesthetist was to avoid morbidity and mortality associated with excessively deep anaesthesia. The introduction of curare in 1942 allowed muscle relaxation required for surgery during a lighter level of anaesthesia, but also changed the emphasis from the problem of too deep anaesthesia and death, to too light anaesthesia and litigation. The problem of awareness during general anaesthesia with muscle relaxants provided the main impetus for monitoring depth of anaesthesia. During daily clinical practice the anaesthesiologist relies on clinical signs to evaluate anaesthetic depth, although several studies have shown a poor correlation between the 2 (Cullen et al. 1972; Evans and Davies 1984; Russell 1993). Different methods have been used in attempts to measure anaesthetic depth (Evans and Davies 1984; Stanski 1994), but none have been developed to a state where they can be used routinely in the operating theatre. This review will cover some of the parameters used to evaluate anaesthetic depth.  相似文献   

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