摘要
目的观察全凭静脉麻醉下腹腔镜手术镇痛/伤害性刺激指数(ANI)与血流动力学指标的相关性。方法便利取样法2018年3月至2020年4月就诊于利津县中心医院的择期腹腔镜手术者,取其中应用全凭静脉麻醉患者125例(男68例、女57例,年龄范围为20~65岁),记录患者麻醉前、气腹前、手术完成时的ANI、收缩压(SBP)、舒张压(DBP)、心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2)),应用Spearman相关分析及偏相关分析确定数据间相关性。结果经方差分析,在不同时间点[入手术室5 min(T1)、麻醉诱导5 min(T2)、气腹后5 min(T3)、手术结束后5 min(T4)]的ANI[(50.56±5.28)、(66.42±3.72)、(75.26±6.74)、(73.46±5.72)]、SBP[(110.35±10.26)、(100.34±10.37)、(106.72±15.39)、(96.45±6.72)mmHg(1 mmHg=0.133 kPa)]、DBP[(75.56±4.67)、(62.56±7.38)、(67.52±4.31)、(70.52±5.41)mmHg]、HR[(76.12±10.56)、(70.42±6.96)、(56.34±6.32)、(72.33±5.69)次/min]、MAP[(86.42±0.89)、(76.42±1.07)、(97.52±0.75)、(78.52±4.39)mmHg]、SpO_(2)[(99.52±0.99)%、(98.72±1.06)%、(96.42±1.11)%、(97.41±0.98)%]比较,差异均有统计学意义(均P<0.05);以时间为横轴、ANI或血流动力学指标为纵轴,计算曲线下面积,ANI与SBP、HR、MAP存在显著正相关(r=0.462、0.452、0.364,均P<0.05);以具体值计入统计,ANI在不同时间点,与SBP、HR、MAP间存在显著负相关(r_(SBP)=-0.349、-0.312、-0.526、-0.349,r_(HR)=-0.339、-0.302、-0.496、-0.376;r_(MAP)=-0.431、-0.328、-0.523、-0.411;均P<0.05);ANI与SBP、HR、MAP间均存在偏相关(r=-0.098、-0.243、-0.249,均P<0.001)。结论全凭静脉麻醉下腹腔镜手术患者的ANI与SBP、HR、MAP存在负相关性,可作为腹腔镜手术的镇痛效果的监测指标。
Objective To study the correlations between analgesia nociception index(ANI)and hemodynamic indexes of laparoscopic surgery under total intravenous anesthesia.Methods Convenient sampling method was used to select patients scheduled for laparoscopic surgery in Central Hospital of Lijin County from March 2018 to April 2020,among them 125 patients underwent total intravenous anesthesia,including 68 males and 57 females,aged from 20 to 65.ANI,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SpO_(2))were recorded before the anesthesia,before the pneumoperitoneum,and at the end of surgery.Spearman correlation analysis and partial correlation analysis were used to determine the correlations between the data.Results Variance analysis showed that there were statistically significant differences in ANI at different time points[5 min after entering the operating room(T1),5 min after the anesthesia induction(T2),5 min after the pneumoperitoneum(T3),and5minaftertheoperation(T4)][(50.56±5.28),(66.42±3.72),(75.26±6.74),and(73.46±5.72)],SBP[(110.35±10.26),(100.34±10.37),(106.72±15.34),and(96.45±6.72)mmHg(1 mmHg=0.133 kPa)],DBP[(75.56±4.67),(62.56±7.38),(67.52±4.31),and(70.52±5.41)mmHg],HR[(76.12±10.56),(70.42±6.96),(56.34±6.32),and(72.33±5.69)beats/min],MAP[(86.42±0.89),(76.42±1.07),(97.52±0.75),and(78.52±4.39)mmHg],and SpO_(2)[(99.52±0.99)%,(98.72±1.06)%,(96.42±1.11)%,and(97.41±0.98)%](all P<0.05).Taking time as the horizontal axis,ANI or hemodynamic indexes as the vertical axis,the area under the curve was calculated,and ANI was significantly positively correlated with SBP,HR,and MAP(r=0.462,0.452,0.364,all P<0.05).ANI was negatively correlated with SBP,HR,and MAP at different time points(r_(SBP)=-0.349,-0.312,-0.526,-0.349;r_(HR)=-0.339,-0.302,-0.496,-0.376;r_(MAP)=-0.431,-0.328,-0.523,-0.411;all P<0.05).ANI was partially correlated with SBP,HR,and MAP(r=-0.098,-0.243,-0.249,all P<0.001).Conclusion ANI is negatively correlated with SBP,HR,and MAP in patients undergoing laparoscopic surgery under total intravenous anesthesia,which can be used as a monitoring index for the analgesic effect of laparoscopic surgery.
作者
刘顺兴
刘乐乐
Liu Shunxing;Liu Lele(Central Hospital of Lijin County,Dongying 257400,China)
出处
《国际医药卫生导报》
2021年第18期2930-2933,共4页
International Medicine and Health Guidance News
关键词
腹腔镜
镇痛/伤害性刺激指数
血压
心率
Laparoscopy
Analgesia nociception index
Blood pressure
Heart rate
作者简介
通信作者:刘顺兴,Email:gang59497445@163.com。
