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ANI-guided Intraoperative Analgesia vs Conventional Intraoperative Analgesia

Not Applicable
Completed
Conditions
Surgery
Analgesia
Postoperative Pain
Interventions
Procedure: Conventional intraoperative analgesia
Procedure: ANI-guided intraoperative analgesia
Registration Number
NCT04877574
Lead Sponsor
Seoul National University Hospital
Brief Summary

This study evaluates the effects of Analgesia Nociception Index (ANI)-guided intraoperative analgesia on postoperative pain in patients undergoing open gynecologic surgery.

Detailed Description

Postoperative pain is one of the most common postoperative complications and is significantly associated with patient's quality of recovery. Analgesia Nociception Index (ANI) is known to analyze the high frequency component of heart rate variability in relation to respiratory frequency, providing the objective information on the degree of pain. However, most previous studies conducted by using ANI were observational studies or small-sized randomized controlled studies. In the present study, the investigators aimed to evaluate the effects of ANI-guided intraoperative analgesia on moderate-to-severe postoperative pain by performing randomized controlled study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
170
Inclusion Criteria
  • Age ≥ 18
  • Elective open gynecological surgery
  • American Society of Anaesthesiologists physical status classification 1-3
Exclusion Criteria
  • Laparoscopic surgery or robot-assisted surgery
  • Patients who had analgesic agents, anti-psychotic agents, anticonvulsants which were related to chronic pain
  • Patients who had hypersensitivity to analgesic agents or medications related anesthesia.
  • Patients who were required to have mechanical ventilation after surgery
  • Patients who had arrhythmia
  • Patients who transferred to the surgical intensive care unit immediately after surgery
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional intraoperative analgesiaConventional intraoperative analgesiaIntraoperative analgesia is performed by controlling the effect-site concentration of remifentanil at the discretion of attending anesthesiologists based on hemodynamic parameters.
ANI-guided intraoperative analgesiaANI-guided intraoperative analgesiaIntraoperative analgesia is performed by controlling the effect-site concentration of remifentanil to maintain 50-70 of ANI index.
Primary Outcome Measures
NameTimeMethod
the incidence of moderate-to-severe postoperative painduring 1 hour of stay in the postanesthesia care unit

the incidence of moderate-to-severe postoperative pain is defined as a case in which pain with numeric rating scale (NRS) of 5 or more is reported during stays in the postanesthesia care unit. Pain assessment is performed two times during stays in the postanesthesia care unit.

Secondary Outcome Measures
NameTimeMethod
the amount of intraoperative remifentanilintraoperative

the amount of intraoperative remifentanil used during anesthesia

Quality of Recovery-15 (QoR-15) scoreat postoperative 24 hour

QoR-15 questionnaire is recorded by an investigator. QoR-15 questionnaire has minimum score of 0 and maximum score of 150, and higher score indicates the better quality of recovery.

11-pointed NRS pain scoreat postoperative 24 hour

11-pointed NRS pain score is measured at both resting state and movement. 11-pointed NRS pain score has minimum score of 0 and maximum score of 10, and higher score indicates the higher severity of pain.

the incidence of postoperative nausea and vomitingat postoperative 1 hour, 24 hour, 72 hour

the incidence of postoperative nausea and vomiting is recorded by an investigator

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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