Comparison of Surgical Pleth Index Guided Analgesia With Standard Clinical Practise During Balanced Anesthesia
Overview
- Phase
- Not Applicable
- Intervention
- administration of sufentanil
- Conditions
- Balanced Anesthesia
- Sponsor
- University Hospital Schleswig-Holstein
- Enrollment
- 82
- Locations
- 1
- Primary Endpoint
- Sufentanil consumption
- Status
- Completed
- Last Updated
- 13 years ago
Overview
Brief Summary
The aim of the present study was to compare SPI guided analgesia with standard clinical practise during general anesthesia using a balanced setting of sevoflurane and sufentanil anesthesia. It was to be tested whether SPI guided analgesia leads to more cardiovascular stability, less use of analgetics and shorter recovery from anesthesia.
Detailed Description
General anesthesia can be considered as a combination of hypnosis, antinociception, and immobility. The monitoring of hypnosis and immobility has been established in clinical practise, however for the evaluation of antinociception a valid monitoring is missing. The Surgical Pleth Index (SPI; former named Surgical Stress Index-SSI) is a multivariate index derived non invasively from finger plethysmographic signal. It has been demonstrated to correlate with surgical stress intensity. In the setting of total intravenous anesthesia TIVA our group could show beneficial effects of SPI guided analgesia in terms of remifentanil consumption, hemodynamic stability and incidence of unwanted events. Therefore, we wanted examine whether these beneficial effects of SPI guided anesthesia can be transferred to a setting of balanced anesthesia using a volatile anesthetic sevoflurane and the opioid sufentanil. The following hypotheses have been made: 1. SPI guided analgesia will result in less sufentanil consumption 2. SPI guided analgesia will result in more hemodynamic stability and faster recovery of the patient after anesthesia, and less opioid use in post operative period
Investigators
Berthold Bein
Prof. Dr. med.
University Hospital Schleswig-Holstein
Eligibility Criteria
Inclusion Criteria
- •age between 18 - 65 years
- •ASA physical status I or II
- •elective surgery under general anesthesia of 1-2 hours
- •written informed consent
Exclusion Criteria
- •pregnancy
- •history of cardiac arrhythmia
- •presence of any neuromuscular opr neurologic disease
- •use of CNS active medication or alcohol/illicit drug abuse -
Arms & Interventions
SPI guided arm
sufentanil was adjusted to SPI level
Intervention: administration of sufentanil
Standard practise
Sufentanil was given at standard practise
Intervention: sufentanil
Outcomes
Primary Outcomes
Sufentanil consumption
Time Frame: during induction and end of anesthesia (1-3 hours)
We will measure the sufentanil consumption during beginning of anesthesia and extubation in microgram per hour.
Secondary Outcomes
- hemodynamic stability(from beginning of anesthesia until discharge to ward (1day))