MedPath

ANI and SPI Guided Intraoperative Analgesia

Registration Number
NCT02490540
Lead Sponsor
University Hospital Hradec Kralove
Brief Summary

There is accumulating evidence that inappropriate analgesia is asssociated with increasing risk of perioperative complications. The aim of the study is to compare intraoperative analgesia guided according to different methods of intraoperative analgesia monitoring, ANI and SPI respectively.

Detailed Description

The Surgical Pleth Index (SPI) and ANI (Analgesia Nociception Index) has been developed for monitoring of adequacy of analgesia during surgery.

The investigators want to compare anesthesiologist guided intraoperative analgesia with intraoperative analgesia guieded by ANI or SPI.

The following hypotheses have been made:

1. Anesthesiologist guided analgesia will result in lower surgical stress

2. Anesthesiologist guided analgesia will result in more hemodynamic stability and faster recovery of the patient after anesthesia

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
72
Inclusion Criteria
  • Patients undergoing scheduled neurosurgical procedures under general anesthesia
  • GCS 15
  • ASA physical status I - III
  • elective procedures with estimated duration 1 - 3 hours
Exclusion Criteria
  • Presence of non-sinus rhythm
  • pacemaker
  • planned postoperative ventilation
  • procedures with planned awake intervals
  • chronic pain with opioid medication
  • opioid addiction
  • epidural administration of local anaesthetic in combination with opioid
  • corticosteroid use
  • hormonal contraception
  • chronic respiratory disease with known respiratory failure

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Anesthesiologist quided analgesiaSufentanil anesthesiologist analgesiaSufentanil anesthesiologist analgesia is based on anesthesiologist decision.
SPI guided analgesiaSufentanil SPI analgesiaSufentanil SPI analgesia is based on the SPI analgesia monitor figures.
ANI guided analgesiaSufentanil ANI analgesiaSufentanil ANI analgesia based on ANI analgesia monitor figures.
Primary Outcome Measures
NameTimeMethod
Cortisol serum levelEnd of surgery

nmol/l

Secondary Outcome Measures
NameTimeMethod
Time to spontaneous ventilationFrom the end of anesthesia up to two hours

min

Mean pain intensity at the ICU/recovery roomFrom the admission to the ICU or recovery room up to 2 hours postoperatively

Mean value of pain intensity score using verbal pain scale (range 0-4)

Number of doses of opioid analgesicsUntil the end of the 3rd postoperative day

The total number of doses of opioid analgesics during the 3 postoperative days

Postoperative respiratory complicationsParticipants will be followed for the duration of hospital stay, an expected average of 2 weeks

Number of participants with postoperative respiratory complications

Sufentanil doseFrom the beginning of anesthesia up to the end of anesthesia, an expacted average duration of 2 hours

microgramms per hour

Pain intensity at recovery room admissionAt the time of ICU/recovery room admission, up to 15 minutes after ICU/recovery admission

Assessment of pain using verbal pain scale (range 0-4)

Time to achievement of normal end-tidal CO2 valueFrom the end of anesthesia up to two hours

min

Pain intensity3rd postoperative day

Assessment of pain using verbal pain scale (range 0-4)

Number of doses of non-opioid analgesicsUntil the end of the 3rd postoperative day

The total number of doses of non-opioid analgesics during the 3 postoperative days

Length of postoperative hospital stayFrom the day of surgery up to the end of hospital stay, an expected average of 2 weeks

days

Time to extubationFrom the end of anesthesia up to two hours

min

Pain intensity at the time of departure from the operating theaterAt the time of departure from the operating room, up to 30 min from the end of anesthesia

Assessment of pain using verbal pain scale (range 0-4)

Trial Locations

Locations (1)

University Hospital Hradec Kralove

🇨🇿

Hradec Kralove, Czechia

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