Klinik für Anästhesiologie, Charité-Universitätsmedizin Berlin, Germany.
Anaesthesia. 2012 Aug;67(8):899-905. doi: 10.1111/j.1365-2044.2012.07187.x. Epub 2012 May 18.
Movement and haemodynamic responses to noxious stimuli during general anaesthesia are regarded as signs of nociception. We compared the Nociceptive Flexion Reflex Threshold (NFRT), Bispectral Index (BIS), Composite Variability Index (CVI), Noxious Stimulation Response Index (NSRI) and the calculated propofol/remifentanil effect-compartment concentrations (Ce) as predictors for such responses in 50 female subjects at laryngeal mask airway insertion and skin incision. The following prediction probabilities (PK-values) were obtained at laryngeal mask airway insertion and skin incision, respectively. For movement responses: NFRT = 0.77 and 0.72; p = 0.0001 and 0.004, respectively; BIS = 0.41 and 0.56, p = 0.29 and 0.5, respectively; CVI = 0.48 and 0.57, p = 0.76 and 0.88, respectively; NSRI = 0.49 and 0.76, p = 0.92 and 0.0001, respectively; propofol-Ce = 0.35 and 0.66, p = 0.04 and 0.03, respectively; remifentanil-Ce = 0.68 and 0.72, p = 0.01 and 0.003, respectively. For heart rate responses: NFRT = 0.68 and 0.75, p = 0.04 and 0.01, respectively; BIS = 0.37 and 0.59, p = 0.15 and 0.41, respectively; CVI = 0.41 and 0.44, p = 0.39 and 0.37, respectively; NSRI = 0.48 and 0.53, p = 0.84 and 0.78, respectively; propofol-Ce = 0.42 and 0.56, p = 0.39 and 0.53, respectively; remifentanil-Ce = 0.58 and 0.54, p = 0.35 and 0.73, respectively. We conclude that the NFRT best predicts movement and heart rate responses to noxious stimuli. Effect-compartment concentrations and NSRI also predict movement (but not heart rate) responses satisfactorily.
在全身麻醉期间，对有害刺激的运动和血液动力学反应被认为是伤害感受的迹象。我们比较了伤害性屈肌反射阈值（NFRT）、双谱指数（BIS）、综合变异指数（CVI）、伤害性刺激反应指数（NSRI）和计算的丙泊酚/瑞芬太尼效应室浓度（Ce），以预测 50 名女性在插入喉罩和切开皮肤时的这些反应。在插入喉罩和切开皮肤时，分别获得以下预测概率（PK 值）。对于运动反应：NFRT=0.77 和 0.72；p=0.0001 和 0.004；BIS=0.41 和 0.56；p=0.29 和 0.5；CVI=0.48 和 0.57；p=0.76 和 0.88；NSRI=0.49 和 0.76；p=0.92 和 0.0001；丙泊酚-Ce=0.35 和 0.66；p=0.04 和 0.03；瑞芬太尼-Ce=0.68 和 0.72；p=0.01 和 0.003。对于心率反应：NFRT=0.68 和 0.75；p=0.04 和 0.01；BIS=0.37 和 0.59；p=0.15 和 0.41；CVI=0.41 和 0.44；p=0.39 和 0.37；NSRI=0.48 和 0.53；p=0.84 和 0.78；丙泊酚-Ce=0.42 和 0.56；p=0.39 和 0.53；瑞芬太尼-Ce=0.58 和 0.54；p=0.35 和 0.73。我们得出结论，NFRT 最能预测有害刺激引起的运动和心率反应。效应室浓度和 NSRI 也能很好地预测运动（但不是心率）反应。
