手术体积描计指数联合脑状态指数监测对老年患者腔镜胆囊切除术中瑞芬太尼用量的影响  

Effect of SPI Combined with CSI Monitoring on the Amount of Remifentanil Used in Elderly Patients Undergoing Laparoscopic Cholecystectomy

作　　者：王静 王辰宇 程少君 强博 刘祎洁 孟霜雷 王泽华 WANG Jing;WANG Chenyu;CHENG Shaojun;QIANG Bo;LIU Yijie;MENG Shuanglei;WANG Zehua(The First Clinical College,Changzhi Medical College)

机构地区：[1]长治医学院第一临床学院,山西长治046000 [2]中国人民解放军联勤保障部队第九七〇医院麻醉科 [3]长治医学院附属和平医院麻醉科

出　　处：《长治医学院学报》2024年第6期439-441,446,共4页Journal of Changzhi Medical College

摘　　要：目的:观察手术体积描计指数(SPI)联合脑状态指数(CSI)在老年患者腹腔镜胆囊切除术中对阿片类药物用量指导的可行性。方法:选择腹腔镜胆囊切除术患者40例,年龄≥65岁,ASAⅡ~Ⅲ级。随机分为SPI+CSI监测组(S组)和常规麻醉监测组(C组),每组各20例。记录瑞芬太尼的消耗量和使用时间,术后镇痛药物的追加量,术前、术后24 h患者QoR-15评分。结果:S组瑞芬太尼用量为0.083μg·kg^(-1)·min^(-1)低于C组的0.109μg·kg^(-1)·min^(-1),差异有统计学意义(P<0.05);S组术后镇痛药物使用率为15%,低于C组的45%,差异有统计学意义(P<0.05);2组术前QoR-15量表评分差异无统计学意义(P>0.05),S组术后QoR-15量表评分高于C组(P<0.05)。结论:老年患者腔镜胆囊切除术中,SPI联合CSI指导给药可以明显减少术中阿片类药物的使用,减少术后镇痛药物的追加,提高患者早期恢复质量。Objective:To observe the feasibility of surgical pleth index(SPI)combined with cerebral state index(CSI)in guiding the dosage of opioids during laparoscopic cholecystectomy in elderly patients.Methods:A total of 40 patients with laparoscopic cholecystectomy(age≥65 years old,ASA gradeⅡ~Ⅲ)were selected.Two groups was divided into by the random number table method,which were SPI+CSI monitoring(group S)and conventional anesthesia management group(group C),with 20 patients in each group.The consumption and duration of remifentanil,the additional amount of postoperative analgesics,and the QoR-15 scores of patients 24 h before and after surgery.Results:The dosage of remifentanil in group S was 0.083μg^(-1)·min^(-1),which was lower than that in group C by 0.109μg^(-1)·min^(-1),and the difference was statistically significant(P<0.05).The postoperative analgesic drug usage rate in group S was 15%lower than 45%in group C,and the difference was statistically significant(P<0.05).There was no significant difference in the QoR-15 score between the two groups before surgery(P>0.05),and the QoR-15 score in group S was higher than in group C after surgery(P<0.05).Conclusion:In elderly patients undergoing endoscopic cholecystectomy,SPI combined with CSI guided administration can significantly reduce the use of intraoperative opioids,reduce the addition of postoperative analgesics and promote the early recovery quality of patients.

关 键 词：手术体积描计指数 麻醉深度指数 围术期镇痛 

分 类 号：R614.2[医药卫生—麻醉学]