CN106730110A

CN106730110A - A kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring

Info

Publication number: CN106730110A
Application number: CN201611092740.8A
Authority: CN
Inventors: 谢言虎; 柴小青; 夏敏; 吕曼曼
Original assignee: Individual
Current assignee: Individual
Priority date: 2016-12-01
Filing date: 2016-12-01
Publication date: 2017-05-31

Abstract

The invention discloses a kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring, including central processing unit control module, BIS sedation depths and vital sign monitoring feedback module, output request module, output performing module four module composition, the present invention, using target controlled infusion as patient-controlled administering mode, target controlled infusion is to calculate therapeutic regimen for pharmacodynamics according to colony's medicine by computer, it is target control target with blood plasma/effect compartment drug concentration, can be rapidly reached or adjust, ensure that steady and certain security of level of sedation, and use BIS sedation depths monitoring system to monitor the sedation depth of patient, with reference to vital sign index, more improve clinical safety.

Description

A kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring

Technical field

The invention belongs to the technical field of Medical Devices, specially a kind of patient-controlled sedation based on anesthesia depth monitoring Target-controlled infusion system.

Background technology

In clinical position, patient is past when receiving endoscopy or being undergone surgery under nerve block and intravertebral anesthesia Toward that can produce different degrees of anxiety and anxiety, to eliminate this unhealthy emotion, anesthetist can typically give patient certain agent The anesthetic and sedative drugs thing of amount is alleviated or is eliminated, but calm not enough or excessive sedation phenomenon inevitably occurs, meets The calm demand of patient or adverse consequences is not caused.

Patient-controlled sedation (PCS, patient controlled sedation) refers to patient in the uneasiness that experiences anxiety When, downern dosage is decided in its sole discretion to realize being satisfied with the sedation methods of sedation effect.The past patient-controlled sedation is logical Assumed load amount, background infusion, single-dose amount and the mode of locking time is crossed to realize, but because patient is reacted downern Difference is big, and blood concentration is unstable, it is likely that the unstable situations of sedation depth such as calm not enough or excessive sedation occur, sternly Weight when even respiration inhibition, threat to life.

Target-controlled infusion system (TCI, target controlled infusion) is extensive in clinical anesthesia work Using according to the pharmacokinetics of medicine and pharmacodynamics and the essential information of patient, the blood required for setting can be input into Concentration, is the best means of clinical treatment individuation.BIS (bispectral index) BIS Propofol-targeted, can be by generation The EEG signals of table difference level of sedation are picked out, and are standardized digitized processing, change into simple quantizating index, no It is only closely related with physiologic sleep, also it has been at present the conventional monitoring index of clinical detection depth of anesthesia, with higher special Property and sensitivity.

Therefore, the combination of target-controlled infusion system and patient-controlled sedation, and under BIS anesthesia depth monitorings, patient can be with The blood concentration of stabilization is rapidly achieved and maintained according to their needs, and is adjusted in time, it is to avoid the generation of adverse reaction, carry significantly Clinical safety high.

The content of the invention

It is real it is an object of the invention to provide a kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring Existing patient-controlled sedation target-controlled infusion system.The defect of prior art can be overcome, mesh is quickly obtained using target controlled infusion technology Mark blood medicine/effect-site concentration, it is ensured that the stationarity of sedation depth, patient monitors in depth of anesthesia and major vital sign simultaneously Under, it is ensured that calm security, while patient-controlled administration, autonomous to participate in, it is really achieved clinical real safely and effectively patient certainly Control sedation effect.

In order to solve the above-mentioned technical problem, the technical solution adopted by the present invention is：

A kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring, including central processing unit control mould Block, BIS sedation depths and vital sign monitoring feedback module, output request module, output performing module four module composition, its In：

Central processing unit control module is microcomputer control system, and central processing unit control module includes man-machine input block And display unit, the calm and major vital signs threshold values that man-machine input block is used to be input into the essential information of patient and sets, Display unit is used to show essential information, major vital sign and the BIS numerical value of patient, correctly enter in advance patient sex, The essential informations such as age, body weight, and according to consulting literatures and expert database setting proper background infusion dosage and sedation depth And major vital signs threshold values, for receiving the calmness depth that BIS sedation depths and vital sign monitoring feedback module are sended over Degree and vital sign information, and be compared with sedation depth threshold value and vital sign, and decide whether further to perform patient Medicine pressing request, when depth of anesthesia or vital sign exceed preset range, central processing system then disregards patient will Ask the request for increasing target control concentration；

BIS sedation depths and vital sign monitoring modular：Including patient monitor, anaesthesia deepness monitoring instrument, real-time monitoring patient Sedation depth index and the arteries and veins oxygen saturation of patient, blood pressure, heart rate, respiratory rate etc. major vital sign, and by calmness Depth and vital sign information pass to central processing unit control module, if BIS value >=75, or vital sign indices are setting Determine in normal range (NR), patient can continue to press administration or stop according to self calm assessment；If BIS<75 or vital sign in Not in normal range (NR), any of which situation any one index occurs, then it is assumed that calm too deep, should not continue to deepen fiber crops Liquor-saturated, the request that now continuation of the central control module then to patient is pressed is refused to perform, and target control pump concentration is not lifted by instruction, Ensure patient safety；

Output request module：Administration request unit, during Patient-controlled sedation pressing administration, this request instruction is passed to Central processing unit control module, central processing unit decides whether to perform the pressing request of patient according to feedback information；

Output performing module：Administration execution unit, specifically refers to target control pump, and central processing unit control module receives patient Pressing information, and determine whether perform for the pressing request of patient according to sedation depth and major vital sign.

The beneficial effects of the invention are as follows：

Present invention, avoiding the administering mode of conventional patients' Patient-controlled Sedation, but using target controlled infusion as patient-controlled administration Mode, target controlled infusion is to calculate therapeutic regimen according to colony's medicine generation-pharmacodynamics by computer, with blood plasma/effect compartment medicine Concentration is target control target, can be rapidly reached or adjust, and ensure that steady and certain security of level of sedation.And make The sedation depth of patient is monitored with BIS sedation depths monitoring system, with reference to vital sign index, clinic is more improve Security, as long as BIS value<75、SpO2<92%th, blood pressure is less than preoperative foundation level 20% or heart rate<50 beats/min there is one kind, Then central processing unit control module is pressed patient and asked, and is not permitted, it is to avoid sedation depth is further deepened, if observation index Target indicator is above, then permits the pressing request of patient, reach the sedation depth of Patients' satisfaction.

Brief description of the drawings

The present invention is further detailed explanation with reference to the accompanying drawings and detailed description.

Fig. 1 is schematic diagram of the present invention.

Specific embodiment

Embodiments of the invention are described in detail below in conjunction with accompanying drawing, but the present invention can be defined by the claims Multitude of different ways with covering is implemented.

As shown in drawings, a kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring, based on BIS monitorings Patient-controlled target control tranquilizing system by central processing unit control module 1, BIS sedation depths and vital sign monitor feedback module 2nd, output request module 3, output performing module 4 four module composition, wherein CPU module 1 receives and BIS is calm deep Degree and vital sign monitoring feedback module 2 and the output signal of request module 3, are simultaneously emitted by instruction controlled output performing module 4, defeated Go out performing module 4 for target control infusion pump, be connected with patient fluid infusion's remaining needle, the other end receives the instruction of central processing module 1, BIS sedation depths and vital sign monitoring feedback module 2 include patient monitor and anaesthesia deepness monitoring instrument, are connected with patient, gather The indexs such as patients' blood, heart rate, oxygen saturation, while anaesthesia deepness monitoring instrument is connected to patients head, gather patient's brain telecommunications Number, reaction is BIS value after calculating treatment in BIS sedation depths and vital sign monitoring feedback module 2, and reaction patient is calm deep Degree, output request module 3 presses and sends the requirement for increasing target control concentration, center by Patients' rights under patient's self judgment Processing module 1 receives sedation depth and the life entity reference that BIS sedation depths and vital sign monitoring feedback module 2 are sended over Breath, and be compared with sedation depth threshold value and vital sign, and decide whether further to perform Patient drug's pressing request, when When depth of anesthesia or vital sign exceed preset range, central processing system 1 then disregards patient requests increases target control concentration Request, output performing module do not work, it is opposite, when depth of anesthesia or vital sign within a predetermined range when, center treatment System 1 will give the request for the treatment of patient requests' increase target control concentration, and output performing module works, and target control infusion pump is to transfusion indwelling Pin liquid medicine injection.

Each part is connected according to such scheme, to man-machine input block input Gender, age, height, body weight etc. Index, sets starting target concentrations, starts infusion, if patient is still conscious under starting target concentrations, can feel anxiety, then can be certainly Row pressing output request module 3, sending command request increases infusion target level, and central processing unit control module 1 receives instruction, together When analysis data from patient monitor and anaesthesia deepness monitoring instrument this moment, the current sedation depth of patient is judged, if BIS value<75 or SpO2<92% or blood pressure be less than preoperative foundation level 20% or heart rate<50 beats/min, then judge that patient's sedation depth has reached safety The lowest limit, central processing unit control module 1 prevents the instruction from patient, and output performing module 4 is stopped；If major vital body BIS value of seeking peace is not below above-mentioned value, then judge that current patents receive sedation depth deficiency, sends instruction, increases target controlled infusion Systemic infusion target level, to reach appropriate sedation effect, present apparatus monitor in real time patient body situation, when BIS sedation depths and Vital sign monitoring feedback module monitors the depth of anesthesia or vital sign of patient body beyond preset range, and modulus are asked in output Block 3 then no longer sends instruction.

Invention described above implementation method, is not intended to limit the scope of the present invention., any in the present invention Spirit and principle within modification, equivalent and the improvement made etc., should be included in claim protection model of the invention Within enclosing.

Claims

1. a kind of patient-controlled sedation target-controlled infusion system based on anesthesia depth monitoring, it is characterised in that processed including center Device control module, BIS sedation depths and vital sign monitoring feedback module, output request module, the output big mould of performing module four Block is constituted, wherein：

Central processing unit control module is microcomputer control system, and central processing unit control module includes man-machine input block and shows Show unit, man-machine input block is used to be input into the essential information of patient and the calmness of setting and major vital signs threshold values, display Unit is used to show essential information, major vital sign and the BIS numerical value of patient, correctly enter in advance the sex of patient, the age, The essential informations such as body weight, and according to consulting literatures and expert database setting proper background infusion dosage and sedation depth and main Vital signs threshold values, for receiving sedation depth and the life that BIS sedation depths and vital sign monitoring feedback module are sended over Life sign information, and is compared with sedation depth threshold value and vital sign, and decide whether further to perform Patient drug by Pressure request, when depth of anesthesia or vital sign exceed preset range, central processing system then disregards patient requests' increase The request of target control concentration；

BIS sedation depths and vital sign monitoring modular：Including patient monitor, anaesthesia deepness monitoring instrument, the town of real-time monitoring patient The arteries and veins oxygen saturation of quiet depth index and patient, blood pressure, heart rate, respiratory rate etc. major vital sign, and by sedation depth And vital sign information passes to central processing unit control module, if BIS value >=75, or vital sign indices are setting just In normal scope, patient can continue to press administration or stop according to self calm assessment；If BIS<75 or vital sign in it is any Not in normal range (NR), any of which situation one index occurs, then it is assumed that calm too deep, should not continue to deepen anesthesia, The request that now continuation of the central control module then to patient is pressed is refused to perform, and target control pump concentration is not lifted by instruction, really Protect patient safety；

Output request module：Administration request unit, during Patient-controlled sedation pressing administration, center is passed to by this request instruction Processor control module, central processing unit decides whether to perform the pressing request of patient according to feedback information；

Output performing module：Administration execution unit, specifically refers to target control pump, and central processing unit control module receives patient depresses Information, and determine whether perform for the pressing request of patient according to sedation depth and major vital sign.