在接受结肠镜检查(CPs)的患者中,静脉镇痛(ISA)期间服用催眠药(HD)和阿片类镇痛药(OA)的剂量不足可能会导致召回(IAwR),术中(IPP)和术后疼痛(PPP),以及术后恶心和呕吐(PONV)。这项研究的目的是评估是否基于状态熵(SE)和手术面积指数(SPI)(麻醉充分性-AoA)的变化值的观察来滴定HD和OA,仅状态熵,或标准实践可以减少不良事件的数量。最终分析中包括了158名患者。与AoA和SE组相比,C组患者的IAwR和IPP发生率在统计学上更高(分别为p<0.01和p<0.05)。反过来,购买力平价率,PONV,两组患者和操作者对ISA的满意度无统计学意义(p>0.05)。血液动力学参数的变化,对高清的需求,和OA有统计学意义,但没有临床价值.在使用异丙酚和FNT的ISA下接受CP的患者中,与标准做法相比,术中SE监测降低了IAwR和IPP的发生率,对购买力平价率没有影响,PONV,或患者和内窥镜医师的满意度。AoA关于异丙酚和FNT滴定的指导,与仅进行SE监控相比,没有减少上述研究参数的发生,施加不必要的额外费用。
In patients undergoing colonoscopy procedures (CPs), inadequate dosing of hypnotic drugs (HD) and opioid analgesics (OA) during intravenous sedoanalgesia (ISA) may lead to intraprocedural awareness with recall (IAwR), intraprocedural (IPP) and postprocedural pain (PPP), as well as postoperative nausea and vomiting (PONV). The aim of this study was to evaluate whether the titration of HD and OA based on the observance of changing values of state entropy (SE) and surgical pleth index (SPI) (adequacy of anesthesia-AoA), state entropy alone, or standard practice may reduce the number of adverse events. One hundred and fifty-eight patients were included in the final analysis. The rate of IAwR and IPP was statistically more frequent in patients from the C group in comparison with the AoA and SE groups (p < 0.01 and p < 0.05, respectively). In turn, the rate of PPP, PONV, and patients\' and operators\' satisfaction with ISA between groups was not statistically significant (p > 0.05). Changes in hemodynamic parameters, demand for HD, and OA were statistically significant, but of no clinical value. In patients undergoing CPs under ISA using propofol and FNT, as compared to standard practice, intraprocedural SE monitoring reduced the rate of IAwR and IPP, with no influence on the rate of PPP, PONV, or patients\' and endoscopists\' satisfaction. AoA guidance on propofol and FNT titration, as compared to SE monitoring only, did not reduce the occurrence of the aforementioned studied parameters, imposing an unnecessary extra cost.