目的：探讨超声导入肿胀麻醉液(肿麻液)对腔内激光治疗下肢静脉曲张术后疼痛的影响。方法：90例下肢静脉曲张患者随机分为研究组和对照组, 每组45例, 研究组在超声导引下行肿麻液注入辅助腔内激光消融治疗; 对照组在超声导引下行传统硬膜外麻醉辅助腔内激光消融治疗。比较两组临床疗效、神经阻滞情况、围术期心率(HR)和平均动脉压(MAP)、术后视觉模拟评分(VAS)以及术后日常活动恢复情况。结果：①研究组治疗总有效率为91.11%, 高于对照组的86.67%, 但两组临床疗效比较差异无统计学意义(P＞0.05)。②研究组神经阻滞起效时间短于对照组(P＜0.05), 研究组5、10、15 min神经阻滞评分高于对照组(P＜0.05), 两组神经阻滞成功率无统计学差异(P＞0.05)。③两组患者手术开始时及术后15、30 min 时HR较术前下降(P＜0.05), MAP较术前升高(P＜0.05), 但两组间不同时点HR及MAP比较, 差异均无统计学意义(P＞0.05)。④两组术后麻醉恢复时 VAS 评分无统计学差异, 但研究组术后2、4、6、8 h VAS 评分低于对照组(P＜0.05)。⑤研究组术后1d、2d、3d日常活动恢复比例均大于对照组(P＜0.05)。结论：在腔内激光消融治疗下肢静脉曲张过程中使用肿麻液能够比传统硬脊膜外腔阻滞麻醉更好地减轻术后疼痛。

麻醉深度监测对提高麻醉质量, 保障患者的手术期安全与康复具有极为重要的意义。系统地回顾了脑电信号分析算法, 主要包括脑电双频指数、麻醉趋势指数、脑状态指数等多种不同参数的算法在麻醉深度监测中的应用研究及进展情况。首先比较了这些参数的脑电分析算法在临床应用中的优缺点, 接着提出了具有优秀去噪能力的排序熵指数算法, 并引入反向映射神经网络对脑电双频指数、麻醉趋势和排序熵指数进行校正优化, 以便更精确地实现麻醉深度监护。最后展望了今后其应用于麻醉深度监测领域的发展前景。

术中麻醉深度监测是保证临床麻醉质量和安全的重要手段, 关系着患者的生命安全。 功能近红外光谱分析技术作为一种非侵入式的脑功能监测技术手段, 能够实现客观可靠的脑神经活动实时监测和成像, 十分适合于进行麻醉深度监测的相关研究。 因此简要介绍了功能近红外光谱分析技术的基本原理和技术实现, 综述了目前功能近红外光谱分析技术在麻醉深度监测相关领域的研究进展, 指出了应用功能近红外光谱进行麻醉深度监测研究的可能途径, 并阐述了亟待解决的重大问题和发展前景。

In the late 1980s and early 1990s, Dr. Britton Chance and his colleagues, using picosecond-long laser pulses, spearheaded the development of time-resolved spectroscopy techniques in an effort to obtain quantitative information about the optical characteristics of the tissue. These efforts by Chance and colleagues expedited the translation of near-infrared spectroscopy (NIRS)-based techniques into a neuroimaging modality for various cognitive studies. Beginning in the early 2000s, Dr. Britton Chance guided and steered the collaboration with the Optical Brain Imaging team at Drexel University toward the development and application of a field deployable continuous wave functional near-infrared spectroscopy (fNIR) system as a means to monitor cognitive functions, particularly during attention and working memory tasks as well as for complex tasks such as war games and air traffic control scenarios performed by healthy volunteers under operational conditions. Further, these collaborative efforts led to various clinical applications, including traumatic brain injury, depth of anesthesia monitoring, pediatric pain assessment, and brain-computer interface in neurology. In this paper, we introduce how these collaborative studies have made fNIR an excellent candidate for specified clinical and research applications, including repeated cortical neuroimaging, bedside or home monitoring, the elicitation of a positive effect, and protocols requiring ecological validity. This paper represents a token of our gratitude to Dr. Britton Chance for his influence and leadership. Through this manuscript we show our appreciation by contributing to his commemoration and through our work we will strive to advance the field of optical brain imaging and promote his legacy.