Effects of surgical pleth index and nociception index on the consumption of remifentanil and postoperative recovery in children undergoing adenotonsillectomy
10.3969/j.issn.1006-5725.2025.13.011
- VernacularTitle:小儿扁桃体腺样体切除术中外科脉搏氧指数和伤害性刺激指数对瑞芬太尼耗量与术后恢复的影响
- Author:
Yuping YE
1
;
Junling LI
;
Guodong LIU
;
Yong WEI
;
Dan XIAO
;
Saijun HUANG
;
Shiyuan XU
Author Information
1. 佛山市妇幼保健院、广东医科大学附属佛山妇女儿童医院手术麻醉科(广东 佛山 528000)
- Publication Type:Journal Article
- Keywords:
nociceptive stimulation monitoring;
pediatric;
adenotonsillectomy;
opioid;
emer-gency agitation
- From:
The Journal of Practical Medicine
2025;41(13):2018-2024
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the appropriate indicators for monitoring pediatric nociceptive stimu-lation,this study compared the SPI and NOX,two dual-parameter nociceptive stimulation monitors based on different principles,in terms of their effects on remifentanil consumption and postoperative recovery in pediatric adenotonsil-lectomy.Methods Children aged 3～12 years who were scheduled to undergo adenotonsillectomy under general anesthesia with endotracheal intubation were randomly assigned to the conventional group(Group R,n=19),the SPI group(Group S,n=19),and the NOX group(Group N,n=18)according to the type of nociceptive stimu-lation monitor used.All children were subjected to routine fasting.The depth of anesthesia was monitored using a BIS monitor,and the remifentanil infusion rate was adjusted according to heart rate,SPI,or NOX values to maintain the index within the range of 30～50.After surgery,all children were transferred to the Post-Anesthesia Care Unit(PACU)with the tracheal catheter in place until they recovered.During the operation,the consumption of anes-thetics such as remifentanil was recorded.Postoperatively,pain and agitation scores,the incidence of agitation at different time points,the duration of anesthesia,the surgical time,the time to extubation,and the length of stay in the recovery room were measured.Additionally,postoperative adverse reactions and perioperative vital signs were documented.Results In comparison with Group R,in Group N,the intraoperative consumption of remifentanil and the agitation score during the recovery period were significantly reduced.Conversely,in Group S,both of(P<0.05).There were no significant disparities in the FLACC score,the incidence of agitation,and the extubation time among the three groups.Conclusions The NOX index can serve as a quantitative metric for monitoring nonci-ceptive stimulation during pediatric adenotonsillectomy.This index has the potential to decrease the intraoperative consumption of opioids and the residence time in the recovery room.
