Effects Of Index Of Consciousness Monitoring On The Quality Of Early Recovery Of Patients After Microvascular Decompression

Objective The purpose of this study was to evaluate the effect of the index of consciousness(IOC)monitoring,that is the combination of sedation(IOC1)and analgesia(IOC2)monitoring on the early recovery quality of patients with microvascular decompression.Methods Selected 60 patients underwent microvascular decompression(clinically diagnosed as facial spasm or trigeminal neuralgia),aged 18 to 65 years,BMI 18-30kg/m2,and ASA physical status I or II.All the patients were divided into two groups(n=30): no monitoring group(group B)and Io C1 combined with Io C2 monitoring group(group I).Patients in both groups were given endotracheal general anesthesia without preoperative medication.After entering the room,venous access was routinely opened.Electrocardiogram(ECG),pulse oxygen saturation(SPO2),heart rate(HR),non-invasive blood pressure(NIBP)were monitored.Both groups of patients were given anesthesia induction by intravenous injection of midazolam,sufentanil,etomidate and rocuronium.After the blood pressure and heart rate were stabilized in group B,endotracheal intubation was performed with Io C1 at 35-45 and Io C2 at 25-35,followed by mechanical ventilation in group I.Then target-controlled infusion of propofol and remifentanil,and continuous anesthesia for sevoflurane inhalation,in which the target plasma concentration range of propofol is 1~4ug/ml,and the target plasma concentration range of remifentanil is 2~5ng/ml.When the dura mater was closed,all patients were given 1 mg/kg of oxycodone intravenously for postoperative analgesia and 20 mg of azasetron to prevent postoperative nausea and vomiting.After the operation,the patient was admitted to PACU.When the VAS score of PACU was?4,tramadol 50 mg was injected intravenously to relieve the pain.When nausea and vomiting occur,intravenous injection of 6 mg of toranstron is given to stop vomiting.The 15-item recovery quality scale(Qor-15 scale)was used to evaluate the early recovery quality of patients 1 day before the operation and 3 days after the operation.The intraoperative dosage of propofol and remifentanil was recorded,the operative time and anaesthesia time were recorded,the postoperative conditions(waking time,extubation time,getting out of bed time,and discharge time)were recorded,and the occurrence of adverse events such as postoperative recovery analgesia,nausea and vomiting were recorded.Results Between the two groups,there was no statistically significant difference in the general data of patients,including age,gender,body mass index,diagnosis(facial spasm / trigeminal neuralgia),operation time,and anesthesia time(P> 0.05).Contrast to group B,the quality of early recovery was higher in group I at 3 days after surgery(P<0.05),and the dosage of propofol and remifentanil was reduced in group I(P<0.05),and the waking time and extubation were significantly shortened(P<0.05).The incidence of postoperative remedial analgesia and adverse events of nausea and vomiting in the two groups was not statistically significant(P>0.05).Conclusion During microvascular decompression,the dual-parameter simultaneous monitoring of Io C1 and Io C2 can significantly shorten patients' waking time and extubation time,reduce patients' consumption of anesthesia,sedation and analgesics,and improve the quality of patients' early postoperative recovery,which is worthy of clinical promotion and application.