Surgical Pleth Index Guided Perioperative Hemodynamics In Patients Undergoing Laparoscopic Cholecystectomy

ObjectiveBy comparing the differences in patients who underwent laparoscopic cholecytectomy perioperative hemodynamics during general anesthesia guided by SPI and standard monitoring,to investigate the meaning of SPI which could stabliize the perioperative hemodynamics,and to provide solid evidence of clinical application in SPI guided general anesthesia.MethodsRefer to inclusion criteria and exclusion criteria,this experiment selected 60 patients who underwent laparoscopic cholecystectomy under general anesthesia.ASA I-II.They were randomly divided into two groups by monitor methods,standard monitoring group(group T,n=30)and surgical pleth index guided analgesia group(group S,n=30).During the maintenance of anesthesia,the group T adjustment were based on standard monitoring,the adjustment of remifentanil in group S were based on blood pressure,heart rate,etc,the group S adjustment were based on SPI.The SBP,DBP,MAP,HR,SE and SPI were recorded when the patients were admitted into the operating room(T0)and immediately induction(T1)and the time(T2),the time 5 min(T3),10 min(T4),15 min(T5),20 min(T6),and 30 min(T7)after the surgery began.The amount of propofol and remifentanil used and the frequency of regulation of the two drugs,the number of patients with circulatory adverse events,the amount of vasoactive drugs used,and the time proportion of hemodynamic target value and the time proportion of hypotension were recorded,the difference of SBP between each time point and the basic value was calculated.Record the SBP,DBP,MAP,HR after the patients were admitted into the PACU(T8).ResultsThere was no significant difference in general data between the two groups((49)>0.05).The dosage of remifentanil in group S were significantly lower than in group T((49)< 0.05),and the number of drug regulation was more than in group T((49)< 0.05).The changes of SE at the time of T2~T3 in the group S were less significant than group T((49)< 0.05).The hemodynamic in group S was more stable((49)<0.05)with less fluctuation while the perioperative hemodynamics was same((49)>0.05),the time proportion of hemodynamic target value was greater than that in group T((49)<0.05).ConclusionDuring laparoscopic cholecytectomy under general anesthesia,using the guidance of SPI could make the hemodynamics more stable,the less use of remifentanil,and no hypotension and hypertension,which benifits to patients’ vital organs and postoperative outcome,purposing pratical application vaule and meaning in clinical anesthesia.