Target-controlled remtfentanil infusion combined with cervical plexus block for anterior cervical decompression surgery / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of target-controlled remifentanil infusion combined with cervical plexus block for anterior cervical decompression surgery.Methods Twenty ASAⅠ or Ⅱpatients aged 30-64 yr undergoing anterior cervical decompression were studied.After a succegsful cervical plexus block,TCI of remifentanil was started at a target plasma concentration(CP)of 1.5 ng/ml 5 min before operation.The remifentanil CP was adjusted according to the patient's response to surgical stimulation and increased or decreased by 0.2 ng/ml each time until Ramsay sedation score reached 2-3 or verbal pain score(VPS)reached 0-1.TCI of remifentanil was discontinued 5 min before the end of surgery.MAP,HR,SpO2,BIS,Ramsay sedation score and VPS were monitored and recorded before cervical plexus block(To,baseline),at 10 min after cervical plexus block(T1),5 min(T2),30 min(T3)after skin incision,when the response to tracheal traction was significant during operation(T4)and at the end of operation(T5).The highest remifentanil Cp and the side effects such as respiratory depression,muscle rigidity,nausea/vomiting and pruritis that occurred were recorded.Remits MAP,SpO2 and BIS were not significantly changed during operation as compared to the baseline values at T0.HR was significantly increased at T2 as compared with the baseline.The Ramsay score reached 2-3 and the VPS reached 0-1 in the majority of patients in group R.No marked side effects were detected during TCI of remifentanil.The remifentanil CP ranged between 1.5-5 ng/ml and the mean CP during operation was(3.4±1.0)ng/ml.Conclusion TCI of remifentanil of low concentration combined with cervical plexus block can safely and effectively induce awake analgesia in patients undergoing anterior cervical decompression surgery.