Effect Of The Surgical Pleth Index On The Amount Of Remife Ntanil Used In Patients Undergoing Lumbar Discectomy With Intravenous Anesthesia

Objective:The purpose of this experiment was to investigate the effect of surgical plethsmography index on total intravenous anesthesia during lumbar intervertebral disc surgery.Method:With the consent of the patients,the ethics committee of our hospital filed for approval.Sixty patients who underwent lumbar discectomy and bone fusion and internal fixation in our hospital from March 2019 to September 2019 were randomly divided into two groups.The surgical pleth index guided analgesia group(S group)30 cases,30 cases in the general anesthesia management analgesia group(group D),both groups were induced by propofol-remifentanil target-controlled induction,and all veins were maintained.BIS in both groups was maintained at 50 ± 5,S Patients in the group adjusted the remifentanil pumping speed to maintain the SPI at 30-50;Group D adjusted the remifentanil pumping speed according to the clinical experience of the anesthesiologist,Cover the SPI window before surgery and retrieve data records after surgery.Both groups were injected intravenously with sufentanil 5ug 30 minutes beforethe end of the operation.Discontinue propofol and remifentanil during suture.Record the general information of the patient,including name,age,gender,weight,BMI,and operation time.Record the consumption of remifentanil and propofol during total anesthesia [total consumption /(body weight × time)].Record the basal heart rate,blood pressure,SPI value before the anaesthesia(T1),the time of intubation(T2),the time of skin peeling(T3),and the operation of 15min(T4),operation 45min(T5),operation 1h(T6),operation 90min(T7),2h(T8)during operation,heart rate,blood pressure,BIS,SPI values at the time of suture(T9).Adverse events recorded during anesthesia included: hypertension(MAP> 100),hypotension(MAP <60),tachycardia(HR> 100 beats / min),and frequency of bradycardia(HR <50 beats / min).The time from the patient’s withdrawal to tracheal tube removal,the patient’s pain score(VAS score),and the awake state score(Steward score)were recorded.Result:A total of 60 subjects completed the experimental study.There was no significant difference in general information between the two groups of patients(P> 0.05);the consumption of remifentanil in group S was lower than that in group D,and the difference was statistically significant(P <0.05).There was no consumption of propofol in the two groups.Significant difference(P> 0.05);there was no significant difference in the BIS value between the two groups(P> 0.05);the SPI values of the twogroups of patients were statistically significant at T4,T5,T6,and T8(P<0.05);blood flow in the S group The study was more stable than the D group,and the difference was statistically significant(P <0.05).There was 1 case in the S group with MAP <60mmHg,and 6 cases in the D group with MAP <60mmHg.There were no significant differences in extubation time,postoperative VAS score,or Steward score between the two groups of patients(P> 0.05).Conclusion:During lumbar intervertebral discectomy and bone graft fusion and internal fixation with intravenous anesthesia,the surgical pleth index can guide the application of remifentanil,and can reduce the consumption of remifentanil compared with conventional anesthesia management.