Peroperative depth of anaesthesia may influence postoperative opioid requirements

Henneberg, Steen Winther; Rosenborg, Desiree; Jensen, EW; Ahn, Poong Gee; Burgdorff, B.; Thomsen, LL

doi:10.1111/j.1399-6576.2005.00598.x

Cited by 25 publications

(23 citation statements)

References 12 publications

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“…The result of their study shows that patients maintained in the lighter plane of anesthesia intraoperatively activated the patient controlled anesthesia (PCA) pump more frequently than those maintained in deeper plane during the first 24 postoperative hours. [5] In these studies, authors speculated that intraoperative deeper plane of anesthesia may have partially aborted the noxious stimuli, influencing the postoperative pain intensity and analgesic requirement.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have shown that adequate intraoperative depth of anesthesia is associated with less postoperative pain and decreased analgesic requirements. [56] The use of clinical signs may not reliably measure the hypnotic component of anesthesia, as they can be affected by factors such as blood volume, cardiac contractility, and drug effects on the cardiovascular system. [7] Bispectral index (BIS) provides a continuous age-independent monitoring of hypnotic state induced by the most widely used sedative-hypnotic agent and has been used to assess the induction quality, depth of anesthesia, intraoperative requirement of anesthetics, postoperative recovery, and to reduce the incidence of intraoperative recall awareness.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study

Sahni

Anand

Gombar

et al. 2011

J Anaesthesiol Clin Pharmacol

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Background:Intraoperative depth of anesthesia may affect postoperative pain relief. This prospective, randomized, and observer-blinded study assessed the effect of intraoperative depth of anesthesia on the postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy.Materials and Methods:A total of 80 patients were randomly divided into two groups of 40 each. A standard technique for anesthesia was followed in all patients. Depth of anesthesia was monitored by bispectral index (BIS) and adjusted with 0.5 to 1.5% isoflurane in group S by addition of propofol in group B, if required, to maintain a BIS value of 45 to 40. Postoperative analgesia was provided by tramadol 1 mg/kg every 6 hours and rescue analgesia by morphine boluses. Postoperative pain was assessed by Visual analogue scale score at 0, 8, 16, and 24 hours.Results:The demographic characteristics were comparable in both groups. The mean BIS value in Group S was 63.32 ± 11.43 and 45.06 ± 15.31 in Group B, well in the range of 40 to 60, reflecting adequate hypnotic effect for general anesthesia. The mean arterial pressure was low in group B throughout the surgery (P<0.05-0.001). The pain score were lower in group B at 0 and 8 hours postoperatively when compared with group S (P<0.05). The rescue analgesic requirement was less in group B, compared with group S (P<0.05).Conclusion:Maintaining BIS to a value of 45 to 40 throughout the surgery results in better postoperative pain relief and decreased requirement of rescue analgesic without any untoward effect.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study

Sahni

Anand

Gombar

et al. 2011

J Anaesthesiol Clin Pharmacol

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“…Studies comparing the two anaesthetic methods are equivocal, with a tendency towards superiority in the TIVA groups in terms of less nausea and earlier start of oral fluid intake (Fassoulaki, 2008;Kroon, 2010). A recent study suggests that deep levels of intraoperative sedation (as measured by auditory evoked potentials) may reduce postoperative morphine demands (Henneberg, 2005). It was conducted using TIVA, but it remains unknown if a similar relationship may be seen with inhalational agents.…”

Section: Anaesthetic Techniquementioning

confidence: 99%

Hysterectomy: Advances in Perioperative Care

Jensen¹,

Børglum²

2012

Hysterectomy

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“…Several methods have been proposed to assess and quantitate the nociceptive response during general anesthesia [8][9][10][11] Autonomic nervous system measures, for example Heart Rate Variability (HRV) [12] or Skin Conductance (SC) [13] and parameters extracted, have been proposed and used by several authors. HRV and SC are correlated with sympathetic activity and therefore, monitors based on these parameters can measure the increase in sympathetic activity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery

Melia¹,

Gabarron²,

Agustí

et al. 2016

J Clin Monit Comput

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Purpose. The objective of this work is to compare the behavior of two electroencephalogram (EEG) based indices after drug induction and during recovery of consciousness.Methods. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. The qCON 2000 monitor (Quantium Medical, Barcelona, Spain) was used to calculate the qCON and qNOX. The fall times and the rise times were defined at the start and at the end of the surgery. Loss of response to verbal command and loss of eye-lash reflex were assessed during the transition from awake to anesthetized, defining the state of loss of consciousness (LOC). Movement as a response to laryngeal mask (LMA) insertion was interpreted as the response to the nociceptive stimuli. The patients were classified as movers or non-movers. The values of qCON and qNOX were statistically compared. Conclusion.The indices qCON and qNOX were able to detect differences between the times of actions of hypnotic and analgesic agents. The qCON showed faster decrease during induction while the qNOX showed a faster increase during recovery.

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Peroperative depth of anaesthesia may influence postoperative opioid requirements

Abstract: The results indicate that the peroperative depth of anaesthesia may have effects on the postoperative analgesic requirements.

Cited by 25 publications

References 12 publications

Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study

Effect of intraoperative depth of anesthesia on postoperative pain and analgesic requirement: A randomized prospective observer blinded study

Hysterectomy: Advances in Perioperative Care

Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery

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