镇痛／伤害性刺激指数评估患者术后疼痛程度的准确性  

Accuracy of analgesia/nociception index in assessing severity of postoperative pain

作　　者：谢海[1] 吴多志[2] 李艳[2] 周期[1] 

机构地区：[1]海南医学院附属医院麻醉科,海口市570102 [2]海南省人民医院麻醉科,海口市570311

出　　处：《中华麻醉学杂志》2016年第6期689-692,共4页Chinese Journal of Anesthesiology

基　　金：海南省卫生计生行业科研项目（15A200004）

摘　　要：目的探讨镇痛／伤害性刺激指数（ANI）评估患者术后疼痛程度的准确性。方法择期外科手术后患者80例，年龄21～77岁，ASA分级Ⅰ-Ⅲ级，术毕拔除气管导管后送PACU，进行ANI监测。于入PACU后即刻（T0）时记录数字疼痛强度量表（NRS）评分，若NRS评分为0～3分，不处理，10min后（T1）再记录NRS评分；若NRS评分为4～10分，静脉注射芬太尼50μg，5min后（T2）再记录NRS评分。同时于T0、T1和T2时记录ANI值。以NRS评分作为评判疼痛程度的标准，采用受试者工作特征曲线分析ANI判断术后疼痛的敏感度和特异度，确定诊断临界值，计算曲线下面积及其95％可信区间。Pearson等级相关分析ANI值和NRS评分的相关性。结果ANI判断术后疼痛程度的曲线下面积（95％可信区间）为0．873（0.816～0．929），诊断临界值为45，敏感度为74．8％，特异度为87．5％。ANI值与NRS评分呈负相关，相关系数为-0．705（P〈0．05）。结论ANI用于评估患者术后疼痛程度的准确性较高，诊断临界值为45。Objective To investigate the accuracy of analgesia/nociception index （ANI） in assessing the severity of postoperative pain in patients. Methods Eighty patients, aged 21-77 yr, of American Society of Anesthesiologists physical status I -III, scheduled for elective operation, were admitted to the postanesthesia care unit after the patients were extubated at the end of operation, and ANI was monitored. Immediately after admission to the postanesthesia care unit （T0 ） , numerical rating scale （NRS） score was recorded. If NRS score was 0-3, the patients received no treatment, and NRS score was recorded again 10 min later （T1）. If NRS score was 4-10, fentanyl 50 μg was injected intravenously, and NRS score was recorded again 5 min later （T2）. ANI value was recorded at To, T1 and T2. NRS score was considered as the criterion for assessment of the severity of pain. The receiver operating characteristic curve was used to analyze the sensitivity and specificity of ANI in determining NRS scores, the cut-off value was determined, and the area under the curve and 95% confidence interval were calculated. Pearson correlation was used to analyze the correlation between ANI and NRS score. Results The area under the curve （95% confidence interval） of ANI in determining NRS scores was 0. 873 （0. 816-0. 929） , and the cut-off value was 45 with a sensitivity of 74. 8% and a specificity of 87.5%. ANI was negatively correlated with NRS score, and the correlation coefficient was -0. 705 （P〈0.05）. Conclusion ANI provides high accuracy in assessing the severity of postoperative pain with a cut-off value of 45 in the patients.

关 键 词：疼痛 手术后 疼痛测定 

分 类 号：R614[医药卫生—麻醉学]