在视频/机器人辅助胸腔镜手术中预测术后疼痛的高频率可变性指数,在综合全身麻醉和外围神经阻塞下:一项观察性研究
Keisuke Yoshida1, Takayuki Hasegawa2, Takahiro Hakozaki2
1Department of Anesthesiology, Fukushima Medical University School of Medicine, 1 Hikariga-Oka, Fukushima, 960-1295, Fukushima, Japan. kei-y7of@fmu.ac.jp.
Journal of clinical monitoring and computing
|August 20, 2024
概括
高频率变化指数 (HFVI) /止痛感知指数 (ANI) 不能可靠地预测手术后疼痛在接受机器人辅助手术的患者. 这一指数与手术后的疼痛评分或吗啡使用没有相关性.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 自主神经系统监控自主神经系统监控
背景情况:
- 高频率变化指数 (HFVI) /止痛感知指数 (ANI) 是评估在全身麻醉期间感觉和止痛平衡的工具.
- 它在预测特定外科手术后的术后疼痛方面的实用性仍在调查中.
研究的目的:
- 调查视频/机器人辅助胸腔镜手术 (VATS/RATS) 患有神经阻塞的患者的手术内HFVI/ANI和术后疼痛之间的相关性.
- 确定不同时间点的HFVI/ANI测量是否可以预测手术后的疼痛严重程度和吗啡消耗.
主要方法:
- 一项观察性研究分析了48名患者的数据,这些患者接受了VATS/RATS在全身麻醉和神经阻塞下.
- 在多个时间点记录了HFVI/ANI值,包括输出管之前,麻醉期间,以及手术/神经阻塞启动后.
- 术后疼痛使用数值评分表 (NRS) 进行评估,并记录了吗啡的消耗.
主要成果:
- 在输出前的HFVI/ANI和术后的NRS得分之间没有发现显著的关联.
- 接收器操作特征 (ROC) 曲线分析表明,HFVI/ANI无法预测中度或重度的术后疼痛.
- 在任何测量时间点中,没有观察到术后吗啡摄入量与HFVI/ANI之间的相关性.
结论:
- 术内HFVI/ANI测量在接受VATS/RATS,全身麻醉和外围神经阻塞的患者中无法有效预测术后疼痛的程度.
- 目前的研究结果表明,在这种患者群体中,使用HFVI/ANI进行个性化疼痛管理策略的局限性.
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