To determine whether Perfusion index can be used as a measurement in pain management during laparoscopic surgeries under general anaesthesia

Not yet recruiting

Brief Summary: Anaesthesia is a state of analgesia, unconsciousness, and muscle paralysis.(1)

In order to broaden our knowledge on this concept, a method to quantify nociception is of the utmost importance. Quantification of nociception under anaesthesia is difficult, and therefore, reaction to nociception is used for monitoring it through increased sympathetic activity or the corresponding decreased parasympathetic stimulation (i.e. increased heart rate (HR)(2). Also, Individualized and situationally fitted intraoperative opioid administration by nociceptionâ€“antinociception balance monitoring helps to avoid opioid overtreatment, opioid-induced hyperalgesia, and adverse effects and shortens the arousal time from anaesthesia.(3,4)

The perfusion index (PI) derived from a pulse oximeter is calculated as the ratio of the pulsatile blood flow to the non-pulsatile blood in peripheral tissue.(5,6) PI can be used to assess peripheral perfusion dynamics due to changes in peripheral vascular tone.(7,8,9) Perfusion index (PI) is a non-invasive and continuous measure of peripheral perfusion.(10,11,12,)The changes in sympathetic tone affect smooth muscle tone and can alter the perfusion, but are not affected by saturation and HR variability.(13-16)We aim to use this parameter to investigate its effectiveness in the assessment of analgesia to painful stimulus under anaesthesia.

Recruitment & Eligibility

Inclusion Criteria

ASA class l and class ll Planned for laparoscopic surgeries under general anesthesia.

Exclusion Criteria

Patients refusing to participate in the study Pregnant females Neurological and psychiatric diseases Chronic pain disorders,peripheral vascular disorders,ischaemic hearts disorders.
Autonomic dysfunction or drugs affecting the autonomic system.

Primary Outcome Measures

Name	Time	Method
To compare changes in the perfusion index to pain stimulus (1st laparoscopic port insertion) & its variability to subsequent pain stimuli (2nd, 3rd & 4th laparoscopic port insertions) after intravenous administration of analgesic dose of fentanyl.	1st laparoscopic port insertion \| 2nd laparoscopic port insertion \| 3rd laparoscopic port insertion \| Every minute up to first 10 minutes followed by every five minutes up to 30 minutes

Secondary Outcome Measures

Name	Time	Method
To compare corresponding changes in perfusion index with dynamic parameters like pulse rate, non invasive blood pressure, mean arterial pressure & oxygen Saturation	1st ,2nd ,3rd ,4th laparoscopic port insertions

Locations (1): KEM Hospital
🇮🇳
Mumbai, MAHARASHTRA, India
KEM Hospital
🇮🇳Mumbai, MAHARASHTRA, India
Dr Manali Mohan Nadkarni
Principal investigator
9820235042
manalinad@gmail.com