SPI在肺癌根治术中指导瑞芬太尼用量的探究

A Study on the Dosage of Remifentanil for Guided by SPI in Thoracoscopic Radical Treatment of Lung Cancer

探讨手术体积描记指数(SPI)在全麻复合胸椎旁神经阻滞(TPVB)下胸腔镜肺癌根治术中作为应激指数指导瑞芬太尼的用量。选取行全麻复合TPVB胸腔镜下肺癌根治术患者120例为研究对象,随机分为低剂量组(A组)、高剂量组(B组),各60例,比较一般资料、围术期数据,分析患者术前术后的各个指标差异和分析不同瑞芬太尼用量组的SPI值变化。结果显示:两组患者在年龄、身高、体重、手术时间、失血量、术后VAS评分、T1与T4时间点的收缩压(SBP)、4个时间点的舒张压(DBP)与心率等的差异均无统计学意义;两组的SPI差异和T2、T3时间点的SBP差异有统计学意义,T1时间点与T2、T3、T4时间点的血压、心率组内存在显著差异。结果表明:瑞芬太尼用量对血流动力学有一定影响,SPI可在全麻复合TPVB胸腔镜肺癌根治术中作为应激指数指导瑞芬太尼的用量。

This paper investigates the use of Surgical Pleth Index(SPI)as a stress index to guide the dosage of remifentanil in endoscopic radical surgery of lung cancer under general anesthesia combined with thoracic paravertebral nerve block(TPVB).120 patients undergoing thoracoscopic radical resection of lung cancer under general anesthesia combined with TPVB are selected as the research objects.We compare the general information and perioperative data and analyze the differences of various indexes before and after surgery as well as the changes of SPI value in the groups with different remifentanil dosages.The results show that there is no significant difference in age,height,weight,operation time,blood loss,postoperative VAS score,systolic blood pressure(SBP)at time points T1 and T4,diastolic blood pressure(DBP)and heart rate at four time points between the two groups;the SPI difference between the two groups and the SBP difference at T2 and T3 time points are statistically significant;there is a significant difference in blood pressure and heart rate between time points T1 and T2~T4.It can be concluded that the dosage of remifentanil has a certain impact on hemodynamics and that SPI can be used as a stress index to guide the dosage of remifentanil during thoracoscopic radical treatment of lung cancer under general anesthesia combined with TPVB.