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吸入麻醉的小波与疼痛评分指数:一项随机对照试验。

Wavelet and pain rating index for inhalation anesthesia: A randomized controlled trial.

作者信息

Zhang Jian-Wen, Lv Zhi-Gan, Kong Ying, Han Chong-Fang, Wang Bao-Guo

机构信息

Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.

Department of Anesthesiology, Shanxi Dayi Hospital, Taiyuan 030032, Shanxi Province, China.

出版信息

World J Clin Cases. 2020 Nov 6;8(21):5221-5234. doi: 10.12998/wjcc.v8.i21.5221.

Abstract

BACKGROUND

Wavelet index (WLi) and pain rating index (PRi) are new parameters for regulating general anesthesia depth based on wavelet analysis.

AIM

To investigate the safety and efficacy of using WLi or PRi in sevoflurane anesthesia.

METHODS

This randomized controlled trial enrolled 66 patients scheduled for elective posterior lumbar interbody fusion surgery under sevoflurane anesthesia between September 2017 and February 2018. A random number generator was used to assign the eligible patients to three groups: Systolic blood pressure (SBP) monitoring group, WLi monitoring group, and PRi monitoring group. The main anesthesiologist was aware of the patient grouping and intervention used. The primary endpoint was anesthesia recovery time. Secondary endpoints included extubation time, sevoflurane consumption, number of unwanted events/ interventions, number of adverse events and postoperative visual analogue scale for pain.

RESULTS

A total of 62 patients were included in the final analysis (SBP group, = 21; WLi group, = 21; and PRi group, = 20). There were no significant differences among the three groups in patient age, gender distribution, body mass index, American Society of Anesthesiologists class, duration of surgery, or duration of anesthesia. Anesthesia recovery time was shorter in the WLi and PRi groups than in the SBP group with no significant difference between the WLi and PRi groups. Extubation time was shorter in the WLi and PRi groups than in the SBP group. Sevoflurane consumption was lower in the WLi and PRi groups than in the SBP group. Nicardipine was more commonly needed to treat hypertension in the WLi and PRi groups than in the SBP group.

CONCLUSION

Regulation of sevoflurane anesthesia depth with WLi or PRi reduced anesthesia recovery time, extubation time and sevoflurane consumption without intraoperative unwanted events.

摘要

背景

小波指数(WLi)和疼痛评分指数(PRi)是基于小波分析调节全身麻醉深度的新参数。

目的

探讨WLi或PRi用于七氟醚麻醉的安全性和有效性。

方法

本随机对照试验纳入了2017年9月至2018年2月期间计划在七氟醚麻醉下进行择期后路腰椎椎间融合手术的66例患者。使用随机数字生成器将符合条件的患者分为三组:收缩压(SBP)监测组、WLi监测组和PRi监测组。主麻醉医生知晓患者分组及所采用的干预措施。主要终点为麻醉恢复时间。次要终点包括拔管时间、七氟醚消耗量、不良事件/干预次数、不良事件数量及术后疼痛视觉模拟评分。

结果

最终分析纳入了62例患者(SBP组,n = 21;WLi组,n = 21;PRi组,n = 20)。三组患者在年龄、性别分布、体重指数、美国麻醉医师协会分级、手术时长或麻醉时长方面无显著差异。WLi组和PRi组的麻醉恢复时间短于SBP组,WLi组和PRi组之间无显著差异。WLi组和PRi组的拔管时间短于SBP组。WLi组和PRi组的七氟醚消耗量低于SBP组。与SBP组相比,WLi组和PRi组更常需要使用尼卡地平治疗高血压。

结论

使用WLi或PRi调节七氟醚麻醉深度可缩短麻醉恢复时间、拔管时间并降低七氟醚消耗量,且术中无不良事件发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6204/7674720/ec016fac6ca4/WJCC-8-5221-g001.jpg

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