A Clinical Observation Application Of NTI Score Of Patients Undergoing Intestinal Polypectomy With Painless Colonoscopy

Objective: The purpose of this study was to To explore the feasibility of maintaining shallow sedation anesthesia in painless intestinal polypectomy by anesthesia trend index(NTI)and traditional sign monitoring methods.Methods:A prospective single blind randomized controlled study was conducted to select 80 patients who underwent painless intestinal polypectomy in our hospital from September 2019 to February 2020.According to random number table method is divided into Narcotrend index(NTI)group(N group)and the Traditional signs monitoring group(R group),using the single blind method,respectively be Narcotrend index,Traditional signs onitoring guide light calm treatment,compared two groups of patients with shallow sedative effect,propofol,fentanyl total dosage,home invasion(T0),immediately into mirror(T1),colon colonoscopy for splenic flexure(T2),after the colon liver area(T3),and wake(T4)in HR,MAP,SP02 value,Pain score,time to wake up,surgically related adverse reactions,etc.RESULTS: 80 patients and two groups were included in the study,all of them successfully completed painless enteroscopy.There were no statistically significant differences between the two groups in age,sex,weight,body mass index,height,ASA classification,polyp size,and polyp number(P > 0.05).Compared with R group,N group had shorter recovery time(0.32 ± 0.04 vs 0.51 ± 0.06,t = 16.663,P=0.000),smaller difference in propofol dosage(80±7 vs 100±10,t=10.363,P=0.000),but the induction time(2.03±0.25 vs 1.97±0.22,t=0.143,P=0.258),operation time(25.12±4.36 vs 23.43±4.38,t=0.324,P=0.752),remifentanil dosage(104.3±8.25 vs100.6±6.33,t=1.423,P=0.159)were equivalent.There was no statistical difference in the basic HR,map and Sp O2 levels between the two groups,and Sp O2 levels were maintained above 98% at each time point,there was no difference between the two groups(P > 0.05).The Map and HR of T1 were significantly lower than that of T0,and there was no significant difference between the two groups(P > 0.05);HR of T2 were statistically significant(P < 0.05);Map of T2,T3 were statistically significant(P < 0.05),and Map and HR of T2,T3,T4 were more stable in group n.There was no significant difference between the two groups in the incidence of hypotension(?~2=0.213),respiratory inhibition(?~2=0.556),nausea and vomiting(?~2=0.213)(P > 0.05),but there was statistical difference between the two groups in the incidence of physical reaction(?~2 = 6.275)and the incidence of total adverse reactions(2=7.680)(P < 0.05).Conclusion:Remifentanil is safe and reliable for shallow sedation anesthesia in the operation of painless intestinal polypectomy,which has the advantages of less respiratory and circulatory inhibition,less propofol consumption,quick recovery and less adverse reactions.Compared with traditional sign monitoring,NTI monitoring can better achieve the goal of shallow sedation anesthesia in patients undergoing painless intestinal polypectomy,and the hemodynamic cycle fluctuation is small,the body motion response is less,and propofol is less during the operation.It can further improve the comfort of patients during operation and reduce the occurrence of adverse reactions.