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Effect of combined intraoperative use of the Nociception Level (NOL) and bispectral (BIS) indexes on desflurane administration.
Renaud-Roy, Etienne; Morisson, Louis; Brulotte, Véronique; Idrissi, Moulay; Godin, Nadia; Fortier, Louis-Philippe; Verdonck, Olivier; Choinière, Manon; Richebé, Philippe.
Afiliación
  • Renaud-Roy E; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada; Department of Anesthesiology and Pain Medicine - Université de Montréal, 2900 Bd Edouard-Montpetit, Montréal, QC, H3T 1J4
  • Morisson L; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
  • Brulotte V; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada; Centre de Recherche de l'Hôpital Maisonneuve-Rosemont (CR-HMR), CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l
  • Idrissi M; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
  • Godin N; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada.
  • Fortier LP; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada; Department of Anesthesiology and Pain Medicine - Université de Montréal, 2900 Bd Edouard-Montpetit, Montréal, QC, H3T 1J4
  • Verdonck O; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada; Department of Anesthesiology and Pain Medicine - Université de Montréal, 2900 Bd Edouard-Montpetit, Montréal, QC, H3T 1J4
  • Choinière M; Department of Anesthesiology and Pain Medicine - Université de Montréal, 2900 Bd Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada; Centre de Recherche du CHUM (CR-CHUM), 900 rue Saint-Denis, Montréal, QC, H2X 0A9, Canada.
  • Richebé P; Department of Anesthesiology and Pain Medicine, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l'Assomption, Montréal, QC, H1T 2M4, Canada; Centre de Recherche de l'Hôpital Maisonneuve-Rosemont (CR-HMR), CIUSSS de l'Est de l'Ile de Montréal, 5415 Boulevard de l
Anaesth Crit Care Pain Med ; 41(3): 101081, 2022 06.
Article en En | MEDLINE | ID: mdl-35472586
BACKGROUND: Currently, nociception monitors are not part of standard anaesthesia care. We investigated whether combined intraoperative nociception (NOL index) and anaesthesia (BIS index) monitoring during general anaesthesia would reduce anaesthetics consumption and enhance intraoperative safety and postoperative recovery when compared to standard of care monitoring (SOC). METHODS: In this randomised study, we included 60 patients undergoing colonic surgery under desflurane/remifentanil anaesthesia and epidural analgesia. Patients received either standard monitoring or combined BIS + NOL index monitoring. In the monitored group, remifentanil infusion was titrated to achieve a NOL index below 20. Desflurane was adjusted to BIS values (45-55). In the SOC group, remifentanil and desflurane were titrated on vital signs and MAC. The primary outcome was intraoperative desflurane consumption. RESULTS: Fifty-five patients were analysed. Desflurane administration was reduced in the monitored group from 0.25 ± 0.05 to 0.20 ± 0.06 mL kg-1 h-1 (p < 0.001). The cumulative time with a BIS under 40 was significantly higher in the SOC group with a median time of 12.6 min (95% CI: 0.6-80.0) versus 2.0 min (95% CI: 0.3-5.83) (p = 0.023). Time for extubation was significantly shorter in the monitored group: 4.4 min (95% CI: 2.4-4.9) versus 6.28 min (95% IC: 5.0-8.2) (p = 0.003). We observed no differences in remifentanil or phenylephrine requirements during anaesthesia or in postoperative outcome measures, such as postoperative pain, opioid consumption, neurocognitive recovery. CONCLUSION: Combined intraoperative monitoring of anaesthesia and nociception during colonic surgery resulted in less desflurane consumption and quicker extubation time compared to standard clinical care monitoring.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anestésicos por Inhalación Tipo de estudio: Clinical_trials Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Anaesth Crit Care Pain Med Año: 2022 Tipo del documento: Article Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anestésicos por Inhalación Tipo de estudio: Clinical_trials Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Anaesth Crit Care Pain Med Año: 2022 Tipo del documento: Article Pais de publicación: Francia