A targeted remifentanil administration protocol based on the analgesia nociception index during vascular surgery

Daccache, G.; Caspersen, Edouard; Pégoix, M.; Monthé-Sagan, Kelly; Berger, L.; Fletcher, Dominique; Hanouz, Jean‐Luc

doi:10.1016/j.accpm.2016.08.006

Cited by 44 publications

(26 citation statements)

References 11 publications

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“…Turan et al 15 reported the significance of ANI monitoring for perioperative analgesia in patients undergoing spinal surgery. Daccache et al, 16 in their prospective study, concluded that ANI monitoring guides remifentanil dosing, and this results in low opioid consumption. Another study, while finding ANI measurements reliable in the sedated patient, pointed out that they may not be as reliable on the awake patient.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effects of dexmedetomidine and remifentanil on pain with the analgesia nociception index in the perioperative period in hysteroscopies under general anesthesia

Gazi

Abitağaoğlu

Turan

et al. 2018

SMJ

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Objectives:To compare analgesia nociception index (ANI) values, visual analog scale (VAS) values, and hemodynamic parameters in hysteroscopy patients who received remifentanil and dexmedetomidine during general anesthesia.Methods:In total, 30 patients who underwent hysteroscopy between March and September 2016 at the University of Health Sciences Fatih Sultan Mehmet Health Research and Application Center, İstanbul, Turkey were included in this prospective study. Standard hemodynamic monitoring, ANI, and bispectral index (BIS) monitoring were applied to the patients. At 10 min prior to induction, 1 µg/kg of remifentanil was applied in Group R (n=15) and 1 µg/kg of dexmedetomidine was applied in Group D (n=15). After induction, sevoflurane was used for maintenance with dexmedetomidine at 0.2-0.7 µg/kg/hour in Group D and remifentanil at 0.05-0.5 µg/kg/minute in Group R. Perioperative and postoperative analgesia levels (ANI and VAS, respectively), hemodynamics, and complications were recorded.Results:Even though the ANI levels in Group D were lower at the perioperative 5th and 10th minutes, the ANI values were between the targeted limits, except for the measurement after I-gel insertion, in both groups. Hemodynamic parameters were within normal limits, but the mean arterial pressures in Group R after induction, following I-gel placement, and at the perioperative 5th, 10th, and 20th minutes were lower and at postoperative 30th minute were significantly higher.Conclusion:Dexmedetomidine and remifentanil are both efficacious agents for perioperative analgesia in hysteroscopy cases.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the effects of dexmedetomidine and remifentanil on pain with the analgesia nociception index in the perioperative period in hysteroscopies under general anesthesia

Gazi

Abitağaoğlu

Turan

et al. 2018

SMJ

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“…ANI-guided intraoperative analgesia has been reported in several publications with overall inconclusive results. Although ANI-guided analgesia may slightly reduce intraoperative opioid consumption, 34 it failed to result in a significant reduction of opioid-related sideeffects. 35,36…”

Section: Single-parameter Scoresmentioning

confidence: 99%

Objective monitoring of nociception: a review of current commercial solutions

Ledowski

2019

British Journal of Anaesthesia

183

141

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Nociception, in contrast to pain, is not a subjective feeling, but the physiological encoding and processing of nociceptive stimuli. However, monitoring nociception remains a challenge in attempts to lower the incidence of acute postoperative pain and the move towards a more automated approach to analgesia and anaesthesia. To date, several commercialised devices promise a more accurate reflection of nociception than the traditionally used vital signs, blood pressure and heart rate. This narrative review presents an overview of existing technologies and commercially available devices, and offers a perspective for future research. Although firm conclusions about individual methods may be premature, none currently appears to offer a sufficiently broad applicability. Furthermore, there is currently no firm evidence for any clinically relevant influence of such devices on patient outcome. However, the available monitors have significantly aided the understanding of underlying mechanisms and identification of potential pitfalls.

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“…Balanced anaesthesia using multiple synergistic agents can attain these goals while minimizing the side effects that may result from high doses of a single agent [1,3]. Opioids are fundamental drugs to achieve a balanced anaesthesia, however, there are clinical situations in which their use is relatively contraindicated, such as opioid intolerance and allergy [1].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have been reporting encouraging results regarding reduction of pain scores, postoperative rescue analgesic consumption and postoperative nausea and vomiting with the use of non-opioid analgesic drugs, namely dexmedetomidine, lidocaine and ketamine, associated with regional anaesthesia [2,3]. Renal transplantation is the ideal treatment for end stage renal disease (ESRD) which is the last stage of chronic kidney disease (CKD) caused most frequently by glomerulonephritis, chronic interstitial nephritis or obstructive syndromes, hereditary or cystic disease [1,4].…”

Section: Introductionmentioning

confidence: 99%

Opioid Sparing Anaesthesia for Living-Donor Renal Transplantation-A Case Report

Pacheco¹,

Pereira²,

Casal³

et al. 2017

J Anesth Clin Res

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Introduction: Opioids have been the mainstay for perioperative analgesia. Non-opioid drugs with analgesic properties improve intraoperative multimodal analgesia and lead to a decrease in analgesic consumption, reduction in pain scores, postoperative rescue analgesia and in postoperative nausea and vomiting. We report a case of a patient with Alport Syndrome and End Stage Renal Disease (ESRD) proposed for elective Living-Donor Renal Transplantation, with reported allergies/intolerance to opioids.

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A targeted remifentanil administration protocol based on the analgesia nociception index during vascular surgery

Cited by 44 publications

References 11 publications

Evaluation of the effects of dexmedetomidine and remifentanil on pain with the analgesia nociception index in the perioperative period in hysteroscopies under general anesthesia

Evaluation of the effects of dexmedetomidine and remifentanil on pain with the analgesia nociception index in the perioperative period in hysteroscopies under general anesthesia

Objective monitoring of nociception: a review of current commercial solutions

Opioid Sparing Anaesthesia for Living-Donor Renal Transplantation-A Case Report

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