| 陈宣求.SPI指导镇痛在全身麻醉下膝关节手术中的应用研究[J].浙江中西医结合杂志,2026,36(5): |
| SPI指导镇痛在全身麻醉下膝关节手术中的应用研究 |
| Application of SPI guided analgesia in knee surgery under general anesthesia |
| 投稿时间：2025-03-06 修订日期：2026-02-26 |
| DOI： |
| 中文关键词: 全身麻醉 膝关节镜 手术体积描记指数 监测 血流动力学 |
| 英文关键词:General anesthesia Knee arthroscopy Surgical plethysmograph index Monitor hemodynamics |
| 基金项目:仙居县人民医院院级课题21yjb03 |
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| 中文摘要: |
| 【】目的 ?探讨全身麻醉下膝关节手术患者采用手术体积描记指数(SPI)指导术中麻醉的临床应用价值。方法 ?采用前瞻性、随机临床试验,选取2023年4月至2024年3月拟在我院接受膝关节镜手术的患者102例,两组患者均采用全麻下手术,研究组51例患者术中接受SPI指导麻醉给药,对照组以常规术中心电及血压监测指导麻醉给药,对比两组患者血流动力学稳定性、应激反应指标、麻醉药物用量、术后恢复情况及不良反应的差异。结果 ?在麻醉诱导前、气管插管时、切皮时、术中、拔管时,研究组和对照组患者的MAP、HR测定值在两组之间比较,两组之间并无明显差异性(P>0.05)；两组患者的MAP、HR在气管插管时、切皮时、术中较麻醉诱导前显著降低,拔管时显著升高,差异均具有统计学意义(P<0.05)； 术前,研究组和对照组患者的血糖、白细胞、hs-CRP、IL-6测定值比较,两组之间并无明显差异性(P>0.05)；术后即刻,研究组患者的血糖、hs-CRP、IL-6测定值均显著低于对照组,差异均具有统计学意义(P<0.05)；研究组的瑞芬太尼用量、丙泊酚用量均少于对照组,研究组的拔管时间短于对照组,差异均具有统计学意义(P<0.05)；研究组和对照组的麻醉时间、手术时间比较,差异无统计学意义(P>0.05)；研究组共有5例发生不良反应,对照组共有13例发生不良反应,研究组患者的不良反应发生率低于对照组(P<0.05)。结论?SPI指导全身麻醉下膝关节镜手术有利于减轻麻醉应激反应、相关麻药用量、降低麻醉引起的并发症发生率。 |
| 英文摘要: |
| 【】Objective ?To investigate the clinical application value of surgical plethysmograph index (SPI) to guide intraoperative anesthesia in patients undergoing knee surgery under general anesthesia.? Methods ?A prospective randomized clinical trial was conducted to select 102 patients who planned to receive knee replacement surgery in our hospital from April 2023 to March 2024. Both groups underwent surgery under general anesthesia. 51 patients in the study group received SPI guidance for anesthesia administration during surgery, while the control group received SPI guidance for anesthesia administration through routine operation center electrical monitoring and blood pressure monitoring. The hemodynamic stability, stress response index, dosage of anesthetic drugs, postoperative recovery and adverse reactions were compared between the two groups.? Results Before anesthesia induction, during tracheal intubation, incision, intraoperative and extubation, there were no significant differences in MAP and HR values between the two groups (P>0.05). Compared with before anesthesia induction, MAP and HR of 2 groups were significantly decreased during endotracheal intubation, skin incision and during operation, and significantly increased during extubation, with statistical significance (P<0.05). Before operation, there was no significant difference in blood glucose, white blood cells, hs-CRP and IL-6 between the study group and the control group (P>0.05). Immediately after surgery, the blood glucose, hs-CRP and IL-6 values of the study group were significantly lower than those of the control group, with statistical significance (P<0.05). The dosage of remifentanil and propofol in the study group were lower than those in the control group, and the extubation time in the study group was shorter than that in the control group, the differences were statistically significant (P<0.05). There was no significant difference in anesthesia time and operation time between the study group and the control group (P>0.05). There were 5 cases of adverse reactions in the study group and 13 cases in the control group. The incidence of adverse reactions in the study group was lower than that in the control group (P<0.05). Conclusion ?SPI guiding knee surgery under general anesthesia is beneficial to reduce the stress reaction of anesthesia, the dosage of related anesthetics, and the incidence of complications caused by anesthesia. |
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