Application Of PTi And Pi Monitoring In Perioperative Analgesia Of Elderly Patients

Objective:To explore the combined application of nalbuphine and dexmedetomidine under the monitoring of PTi,Pi and WLi in the treatment of postoperative pain in elderly patients,so as to achieve precision perioperative anesthesia for elderly patients.Methods:A total of 60 elderly patients who underwent elective laparoscopic colorectal resection in our hospital were selected and randomly divided into the P group（experimental group）and the C group（control group）,with 30 cases in each group.Before induction of anesthesia,dexmedetomidine（0.6μg/kg）and nalbuphine（0.1 mg/kg）were added to 20 ml of normal saline respectively and injected intravenously at a constant speed for 10 minutes in P group.The same amount of normal saline was given to C group at a constant speed for 10 minutes.Record the basic information of the patient,including:age,gender,BMI index,weight,ASA classification;record the patient blood pressure,heart rate,blood oxygen saturation,WLi and PTi at T₀（before operation）,T₁（after administration）,T₂（10 minutes after induction of anesthesia）,T₃（5 minutes after the surgery）,T₄（5 minutes after extubation）and T₅（30 minutes after extubation）;record Pi at T₀,T₄and T₅;record Ramsay sedation score,VAS score,BCS score,and recovery agitation rating at T₄and T₅;record adverse reactions of patients 24 hours after operation including:respiratory depression,body temperature changes,shivering,nausea,and vomiting.Results:There was no significant difference in basic information of the patient（age,gender,BMI index,weight,ASA classification）between two groups（P>0.05）.WLi in P group was lower than that in C group at T₁（P<0.05）,and there was no significant difference among the other time points（P>0.05）.PTi in P group was lower than that in C group at T₁and T₃（P<0.05）,and there was no significant difference among the other time points（P>0.05）.Pi in P group was lower than that in C group at T₄and T₅（P<0.05）,and there was no significant difference at T₁（P>0.05）.MAP in P group was lower than that in C group at T₃（P<0.05）,and there was no significant difference among the other time points（P>0.05）.There was no significant difference in HR between two groups（P>0.05）.Ramsay sedation score in P group was lower than that in C group at T₅（P<0.05）,and there was no significant difference at T₄（P>0.05）.VAS score,BCS score,and recovery agitation rating in P group were significantly different from those in C group at T₄and T₅（P<0.05）.Awakening time of anesthesia in P group was lower than that in C group（P<0.05）.There was no difference in the operation duration between the two groups（P>0.05）.The incidence of adverse reactions 24h after surgery in P group was lower than that in C group（P<0.05）.Conclusion:The combined application of dexmedetomidine and nalbuphine before induction of anesthesia can effectively relieve postoperative pain and reduce the occurrence of adverse reactions within 24 hours after operation;PTi and Pi can reflect the level of analgesia and pain in the perioperative period,which provide guidance for precision anesthesia.