Wang Yu-Lan, Kong Xiao-Qi, Ji Fu-Hai
Department of Anesthesia Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu, China.
J Cardiothorac Surg. 2020 Oct 2;15(1):296. doi: 10.1186/s13019-020-01346-1.
The Surgical Pleth Index (SPI) is a monitoring method that reflects painful stimuli during general anesthesia, and dexmedetomidine is an analgesic adjuvant with an opioid-sparing effect. But up to now, it is still unclear whether dexmedetomidine has any influence on SPI. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery.
We enrolled 94 patients who underwent video-assisted thoracoscopic lung lobectomy. Patients were randomly assigned to a dexmedetomidine group (dexmedetomidine: 0.8 μg/kg administered for 10 min before anesthesia) or normal saline group (equal volume of normal saline). SPI and vital signs were recorded. The number rating scale (NRS) pain score was also evaluated.
SPI values were significantly lower in the dexmedetomidine group than in the normal saline group at intubation and at discharge from the postanesthesia care unit. Compared with the normal saline group, mean arterial pressure and heart rate were both significantly lower in the dexmedetomidine group at intubation. Heart rate was lower at skin incision in the dexmedetomidine group. The NRS score in the normal saline group was noticeably higher vs. the dexmedetomidine group at discharge from the postanesthesia care unit.
Dexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli.
Chinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450 , Registered 16 October, 2016.
手术容积指数（SPI）是一种反映全身麻醉期间疼痛刺激的监测方法，右美托咪定是一种具有阿片类药物节省效应的镇痛辅助药物。但迄今为止，右美托咪定对SPI是否有影响仍不清楚。本研究旨在探讨右美托咪定在电视辅助胸腔镜手术期间对SPI是否有影响。
我们纳入了94例行电视辅助胸腔镜肺叶切除术的患者。患者被随机分为右美托咪定组（右美托咪定：麻醉前10分钟静脉注射0.8μg/kg）或生理盐水组（等体积生理盐水）。记录SPI和生命体征。同时评估数字评分量表（NRS）疼痛评分。
在插管时和麻醉后监护病房出院时，右美托咪定组的SPI值显著低于生理盐水组。与生理盐水组相比，右美托咪定组在插管时的平均动脉压和心率均显著降低。右美托咪定组在皮肤切口时心率较低。在麻醉后监护病房出院时，生理盐水组的NRS评分明显高于右美托咪定组。
右美托咪定降低了术中SPI和NRS评分。我们的结果表明，右美托咪定减轻了有害刺激。
中国临床试验注册中心（ChiCTR）：ChiCTR-OOC-16009450，于2016年10月16日注册。
