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在没有使用肌肉松剂的门诊腹腔镜胆囊切除术期间SPI的变化,使用ANI引导的remifentanil

E Boselli^1,2, B Allaouchiche³

¹Groupement hospitalier Nord-Dauphiné, Service d'anesthésie, Centre Hospitalier Pierre Oudot, Bourgoin-Jallieu, France. emmanuel.boselli@gmail.com.

Journal of clinical monitoring and computing

|May 5, 2025

概括

这项研究发现,在没有肌肉松剂的腹腔镜胆囊切除术期间,针对50-80之间的疼痛感知指数 (ANI) 导致外科普莱特指数 (SPI) 值,表明足够的疼痛感知-抗性感知平衡.

科学领域:

麻醉学麻醉学
手术监测手术监测

背景情况:

精确的感觉监测对于优化手术期间麻醉至关重要.
疼痛感知指数 (ANI) 和外科整形指数 (SPI) 是评估患者感知状态的先进工具.
没有肌肉松剂的腹腔镜胆囊切除术对麻醉管理提出了独特的挑战.

研究的目的:

在没有肌肉松剂进行的门诊腹腔镜胆囊切除术期间比较ANI和SPI值.
在特定麻醉条件下评估ANI和SPI之间的关系.
为了确定是否针对ANI影响SPI和整体的 nociception-antinociception平衡.

主要方法:

对40名经过腹腔镜胆囊切除术而没有肌肉松剂的成年患者进行前性观察性研究.
使用普罗波福,胺和雷米芬坦尼尔诱导麻醉,然后进行双边TAP阻断.
使用remifentanil (目标ANI 50-80) 和desflurane (MAC 0.8-1.2) 而没有肌肉松剂进行麻醉维护.
在不同时间点采集和分析ANI和SPI值,使用重复测量ANOVA和线性回归.

主要成果:

平均ANI值从诱导到输出显著下降,保持在50-80目标范围内.
诱导后,SPI平均值也显著下降,但波动,保持在20-50的目标范围内.
在SPI和ANI之间观察到差但显著的负线性关系 (r2=0.053,p<0.001).
在整个程序中,在没有肌肉松剂的情况下成功维持了麻醉.

结论:

在没有肌肉松剂的腹腔镜胆囊切除术期间,准50-80之间的ANI与SPI值相关,表明足够的 nociception-antinociception平衡.
ANI和SPI之间的相关性很弱,这表明它们提供了互补的信息.
需要进一步的研究来比较ANI和SPI指导的雷米芬坦尼尔给药及其对不同手术环境中的患者结果的影响.

关键词:

止痛药止痛药是一种止痛药.麻醉,吸入的麻醉,吸入的麻醉胆囊切除术,腹腔镜切除术德斯弗兰是一种非化物.监测,手术内监测没有感觉,没有感觉.门诊外科手术门诊外科手术在Remifentanil中使用Remifentanil.

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