基于伤害敏感指数指导的平衡麻醉对日间腹腔镜手术术后康复的影响OA

Objective To investigate the effect of balanced anesthesia guided by nociception index(NOX)on postoperative rehabilitation of daytime laparoscopic surgery.Methods A total of 120 patients undergoing daytime laparoscopic cholecys-tectomy under general anesthesia in the Second Affiliated Hospital of Nanchang University from January to September 2025 were selected as the research objects and randomly divided into NOX1 monitoring group(N1 group),NOX2 monitoring group(N2 group)and control group(C group),with 40 cases in each group.During the operation,the dosage of Propofol and Remifentanil was adjusted according to the change of NOX value in group N1.The dosage of NOX was maintained between 40 and 50.The dosage of Propofol and Remifentanil was adjusted according to the change of NOX value in group N2.The dosage of NOX was maintained between 30 and 40.The hemodynamic fluctuation was regulated by vasoactive drugs.In group C,the dosage of Propofol,Remifentanil and vasoac-tive drugs was adjusted according to the experience of anesthesiologists and hemodynamic changes,so that the fluctuation range of heart rate and blood pressure did not exceed 20％of the basic value.The intraoperative dosage of Propo-fol and remifentanil,the resting state visual analogue scale(VAS)at 2 h(T1),6h(T2),12 h(T3),the dosage of Sufentanil in postoperative patient controlled intravenous analgesia the use of additional analgesics and the total perioperative dosage of Sufentanil were compared among the three groups.The quality of recovery-15(QoR-15)scores before operation and at T3 were compared.The incidence of postoperative nausea,vomiting,pain and other adverse reactions,postoperative first ambulation time,gastrointestinal function recovery time,hospitalization time,hospitalization rate and readmission rate after discharge were recorded.Results The amounts of Propofol and Remifentanil used during the surgeries in groups N1 and N2 were both higher than those in group C.However,the usage of Sufentanil in patient controlled epidural analgesia,the total usage of Sufentanil during the perioperative period,the VAS score at T1-2,the incidence of postoperative nausea and vomiting,pain and other adverse reactions,and the re-hospitalization rate were lower in groups N1 and N2 than in group C,the number of additional remedial analgesia was also less than that in group C,the postoperative first-time standing up time,gastrointestinal function recovery time,hospitalization time were shorter in groups N1 and N2 than in group C,the QoR-15 at T3 score after surgery was higher in groups N1 and N2 than in group C,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the re-hospitalization rate after discharge among the three groups(P＞0.05).There were no statistically significant differences in the intraoperative usage of Propofol,intraoperative usage of remifentanil,patient controlled epidural analgesia Sufentanil usage,total perioperative Sufentanil usage,additional remedial analgesia times,VAS scores at T1-3 moments,QoR-15 score at T3 after surgery,incidence of postoperative nausea and vomiting and pain and other adverse reactions,postoperative first-time standing up time,gastrointestinal function recovery time,hospitalization time,re-hospitalization rate,and re-hospitalization rate after discharge among groups N1 and N2(P＞0.05).Conclusion Balanced anesthesia based on NOX guidance can objectively quantify the level of noxious stim-ulation and the use of narcotic drugs during daytime laparoscopic surgery,reduce the dosage of opioids after operation and perioperative period,reduce the incidence of postoperative adverse reactions,reduce the rate of hospitalization and readmission after discharge,which is conducive to the postoperative rehabilitation of patients undergoing daytime laparoscopic surgery.