Objective_To evaluate the clinical profile of ANI-guided remifentanil administration during posterior lumbar spinal surgery.Methods_Sixty patients undergoing selective posterior lumbar decompression laminectomy and internal fixation were randomized into two groups, ANI-guided analgesia group ( ANI group) and another group which was blinded to ANI ( control group) .In both groups, combined propofol-remifentanil target control infusion ( TCI) was performed, In ANI group, the concentration of remifentanil was adjusted to maintain ANI values be-tween 50 and 70, however, in the control group, remifentanil target concentration was adapted corresponding to HR or BP values.Anesthetics consumption, incidence of unwanted events, interventions, time of open-eyes and extu-bation, VAS0h and VAS1/2h, complementary analgesics, intraoperative awareness, PONV and other symptoms were recorded.Results_Remifentanil consumption was lower in ANI group than that in control group ( P<0.05) . The number of unwanted events( hypotension, bradycardia and total unwanted events) were also less in ANI group than that in control group (P<0.05).Compared with control group, the usage of urapidil was more and the usage of volume expansion was less in ANI group( P<0.05) .There was no significant statistic differences in other index between two groups.Conclusions_ANI-guided remifentanil infusion resulted in application of lower remifentanil administered dose with more stable hemodynamics in posterior lumbar spinal surgery.%目的:评估镇痛/伤害性指数( ANI)指导瑞芬太尼在全麻腰椎后路手术中应用的可行性。方法将60例择期行后路腰椎椎板切除减压内固定术的患者随机分入ANI组或对照组,均采用瑞芬太尼-丙泊酚靶控输注,ANI组根据ANI值(50~70)调整瑞芬太尼靶浓度,而对照组根据心率、血压等调整。记录麻醉药物使用量、术中不希望事件(高血压、低血压、心动过速、心动过缓和体动反应)发生次数及干预措施(阿托品、麻黄素、艾司洛尔、乌拉地尔和快速扩容等)使用情况,记录苏醒时间及疼痛评分,有无术中知晓、恶心呕吐等。结果与对照组比较,ANI组瑞芬太尼用量、低血压和心动过缓发生次数下降(P<0.05),乌拉地尔使用次数增加而快速扩容次数减少(P<0.05),其余指标两组比较无差异。结论在全麻腰椎后路手术中,应用ANI指导麻醉可以减少瑞芬太尼用量,术中血流动力学更加平稳。
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机译:Bloqueio做plexo lombar pela通过后路镇痛pós-operatóriadeartroplastia total do quadril:estudo comparativoentrebupivacaínaa0.5%com epinefrinaeropopacaínaa0.5%Bloqueo del plexo腰椎后路镇痛术后术后动脉粥样硬化总体de cadera: un estudio comparativo entre 0,5%debupivacaínaconepinefrina y 0.5%declopivacaína后路腰椎丛阻滞术后镇痛用于全髋关节置换术:0.5%布比卡因与肾上腺素和0.5%罗哌卡因的对比研究