Clinical Application Of Closed-loop Coadministration Of Propofol And Remifentanil Guided By Narcotrend Index In Cervical Spine Surgery

ObjectiveTo evaluate the value of Narcotrend index(NI)in the application ofpropofol and remifentanil combined with closed loop target controlled infusion anesthesia in cervical spine surgery.MethodsSixty-four patients undergoing cervical spine surgery,ASA ???,were divided into two groups:closed-loop group(group P,n=32)and open-loop group(group A,n=32).The two groups were induced in the same way,when NI drops to less than or equal to 46 and last more than 30s,P group set up NI target controlled infusion of propofol and remifentanil for 36 automatic closed-loop target.A group by anesthesiologists manual adjustment of propofol and remifentanil target concentrations in maintaining NI(26~46).The NI,mean arterial pressures(MAP)and heart rates(HR)were recorded:before induction(T1),after intubation(T2),1 min after endotracheal intubation(T3),before decompression(T4),1 min after decompression(T5),3 min after decompression(T6),5 min after decompression(T7).The dosage of propofol,remifentanil,atropine,ephedrine and urapidil in two groups were calculated.The time proportion of different anesthesia depth(NI26~46,N<26,NI>46)and extubation time between the two groups were calculated.ResultsThere was no significant difference between the two groups in general data(P>0.05).There was no significant difference in anesthesia maintenance time between the two groups(P>0.05),There was no significant difference between the two groups in the rate of NI<26,NI>46,and the percentage of NI 26 to 46(P>0.05)was significantly higher than that in group P(P<0.05).The average maintenance mass concentration of propofol was decreased,and the average concentration of remifentanil was increased(P<0.05),there was no significant difference between the two groups in the dosage of ephedrine,urapidil and atropine(P>0.05).Postoperative extubation time was significantly shorter in group P than in group A(P<0<05).The comparison of two groups of patients with HR,MAP and NI,compared with the T2 moment,T3 moment,HR was increased(P<0.05),compared with the T,moment,T2moment,T4 moment,MAP was decreased(P<0.05),at T3moment and T6 moment were no significant difference in MAP values(P>0· 05),compared with T1,at the other moment,NI was decreased(P<0.05),compared with the A group at T4 moment,T5 moment MAP and NI values were significantly higher(P<0.05),there was no significant difference in T4,T6,T,moment in MAP and NI values(P>0.05).ConclusionNI instructs propofol and remifentanil combined with closed-loop target-controlled infusion for cervical spine surgery anesthesia,which maintains a stable anesthesia depth,compared with the artificial group,the precise regulation of intraoperative blood flow Learn more stable,propofol consumption decreased,wake up more quickly.