Comparison of Surgical Pleth Index-guided analgesia using fentanyl versus conventional analgesia technique in laparoscopic cholecystectomy

Jain, Neeraj; Gera, Anjali; Sharma, Bimla; Sood, Jayashree; Chugh, Parul

doi:10.23736/s0375-9393.18.12954-3

Cited by 23 publications

(37 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, these results require confirmation. On secondary outcomes, no consistent beneficial effect of nociception guided management was observed, although admittedly, some individual well conducted trials show promising effects on intraoperative hemodynamic stability [15] or postoperative pain [16,24,26] (see Table 2). Again, these results need to be confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…However, in absolute values, the reduction in oxycodone from that study equaled to only 2.8 mg morphine. In contrast with these studies, Jain et al found an increased consumption of fentanyl in SPI guided patients during laparoscopic cholecystectomy [16]. This translated to less postoperative pain and a reduced need for postoperative adjuvant analgesia.…”

Section: Surgical Plethysmographic Index (Spi)mentioning

confidence: 95%

“…The first is a randomized trial from our research group that compared nociception level (NOL)guided analgesia with standard clinical care in patients undergoing major abdominal surgery [15]. The second study is a trial that compared SPI guided anesthesia with standard care during laparoscopic cholecystectomy [16]. Our review process therefore resulted in a total of 12 unique studies eligible for inclusion in the review.…”

Section: Study Selectionmentioning

confidence: 99%

“…A total of 1045 patients were studied, with 520 receiving an intervention compared to 526 treated according to routine clinical care. Care guided using the SPI was evaluated in six studies [16][17][18][19][20][21] followed by the ANI in three studies [22][23][24]. The NOL, pupillometry and the beat-to-beat cardiovascular depth of anesthesia index (CARDEAN 2.0) were evaluated in single studies [15,25,26].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six reports were identified that compared SPI guided anesthesia to standard practice [16][17][18][19][20][21]. Studies were diverse with regard to the maintenance hypnotic (propofol or sevoflurane) and opioids (remifentanil/sufentanil/ fentanyl and oxycodone).…”

Section: Surgical Plethysmographic Index (Spi)mentioning

confidence: 99%

See 4 more Smart Citations

Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials

Meijer

Niesters

Velzen

et al. 2019

J Clin Monit Comput

View full text Add to dashboard Cite

Monitors that estimate nociception during anesthesia may be used to guide opioid and other analgesics administration to optimize anesthesia care and possibly outcome. We reviewed the literature to evaluate current evidence of the effect of nociception-guided management over standard anesthesia practice during surgery. A systematic review of the literature on the effect of nociception monitoring on anesthesia practice was conducted. Reports were eligible if they compared nociception-guided anesthesia to standard practice during surgery. Primary endpoint of this review is intraoperative opioid consumption. Secondary endpoints included hemodynamic control, postoperative pain and pain treatment. We identified 12 randomized controlled trials that compared one of five different nociception monitoring techniques to standard anesthesia care. Most studies were single center studies of small sample size. Six studies reported intraoperative opioid consumption as primary outcome. There was considerable variability with respect to surgical procedure and anesthesia technique. For nociception monitors that were investigated by more than one study, analysis of the pooled data was performed. The surgical plethysmographic index was the only monitor for which an intra operative opioid sparing effect was found. For the other monitors, either no effect was detected, or pooled analysis could not be performed due to paucity of study data. On secondary outcomes, no consistent effect of nociception-guided anesthesia could be established. Although some nociception monitors show promising results, no definitive conclusions regarding the effect of nociception monitoring on intraoperative opioid consumption or other anesthesia related outcome can be drawn. Clinical trial number PROSPERO ID 102913.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Surgical Plethysmographic Index (Spi)mentioning

confidence: 95%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Surgical Plethysmographic Index (Spi)mentioning

confidence: 99%

See 3 more Smart Citations

Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials

Meijer

Niesters

Velzen

et al. 2019

J Clin Monit Comput

View full text Add to dashboard Cite

show abstract

Nozizeptionsmonitoring

Nitzschke

Fischer²,

Funcke³

2021

Anaesthesist

View full text Add to dashboard Cite

Does surgical plethysmographic index-guided analgesia affect opioid requirement and extubation time? A systematic review and meta-analysis

Hung

Hsu

et al. 2022

J Anesth

View full text Add to dashboard Cite

Purpose This meta-analysis of all relevant clinical trials investigated surgical plethysmographic index (SPI)-guided analgesia’s efficacy under general anesthesia for perioperative opioid requirement and emergence time after anesthesia. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched up to January 2022 to identify clinical trials comparing SPI-guided and conventional clinical practice for patients who underwent general anesthesia. With the random-effects model, we compared intraoperative opioid consumption, emergence time, postoperative pain, analgesia requirement, and incidence of postoperative nausea and vomiting (PONV). Results Thirteen randomized controlled trials (RCTs) (n = 1314) met our selection criteria. The overall pooled effect sizes of all RCTs indicated that SPI-guided analgesia could not significantly reduce opioid consumption during general anesthesia. SPI-guided analgesia accompanied with hypnosis monitoring could decrease intraoperative opioid consumption (standardized mean difference [SMD] − 0.31, 95% confidence interval [CI] − 0.63 to 0.00) more effectively than SPI without hypnosis monitoring (SMD 1.03, 95% CI 0.53–1.53), showing a significant difference (p < 0.001). SPI-guided analgesia could significantly shorten the emergence time, whether assessed by extubation time (SMD − 0.36, 95% CI − 0.70 to − 0.03, p < 0.05, I2 = 67%) or eye-opening time (SMD − 0.40, 95% CI − 0.63 to − 0.18, p < 0.001, I2 = 54%). SPI-guided analgesia did not affect the incidence of PONV, postoperative pain, and analgesia management. Conclusion SPI-guided analgesia under general anesthesia could enhance recovery after surgery without increasing the postoperative complication risk. However, it did not affect intraoperative opioid requirement. Notably, SPI-guided analgesia with hypnosis monitoring could effectively reduce intraoperative opioid requirement.

show abstract

Comparison of Surgical Pleth Index-guided analgesia using fentanyl versus conventional analgesia technique in laparoscopic cholecystectomy

Cited by 23 publications

References 25 publications

Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials

Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials

Nozizeptionsmonitoring

Does surgical plethysmographic index-guided analgesia affect opioid requirement and extubation time? A systematic review and meta-analysis

Contact Info

Product

Resources

About