Evaluation Of The Analgesia Nociception Index vs. Surgical Pleth Index Under General And Regional Anaesthesia

Evaluation Of The Analgesia Nociception Index vs. Surgical Pleth Index Under General And Regional Anaesthesia And The Effect Of Posture. A Prospective Randomized Controlled Trial.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02744573

Enrollment

Registered

2016-04-20

Start date

2011-09-30

Completion date

2012-12-31

Last updated

2016-04-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Monitoring, Pain, Stress

Brief summary

There is a lack of sufficient analgesia monitoring apart from surrogate parameters. The analgesia nociception index (ANI) shall be evaluated under general and regional anaesthesia.

Detailed description

While sophisticated haemodynamic monitoring as well as depth of neuromuscular block and sedation are established in daily clinical routine monitoring of analgesia remains poorly represented. The surgical pleth index (SPI) algorithm takes into account both central and peripheral sympathetic tone via the normalised heart beat interval and the plethysmographic pulse wave amplitude and has been described before. A more detailed investigation on the SPI and its behaviour under a posture maneuver shows the limitation of the device. Another device developed calculates the analgesia nociception index (ANI) by heart rate variability and was launched into the market in 2010. However, the effect of posture - to our knowledge - has not yet been studied. The change of body positioning during surgery is regularly necessary in order to improve surgical access to anatomic structures. These alterations in positioning are known to be accompanied by changes in haemodynamic parameters. The aim of this study was to evaluate the ANI in patients undergoing elective surgery in lithotomy position.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* ≥ 18 years * Body mass index (BMI) \< 35 kg m2 * American Society of Anesthesiologists (ASA) status I-III * Elective urology and gynaecology surgery in lithotomy position * 15 healthy volunteers were included in the study as a control group

Exclusion criteria

* Age \< 18 years * ASA status IV or higher * BMI ≥ 35 kg m2 * Chronic heart rhythm disorders * Implanted pacemakers * Patients with a history of chronic pain and emergency surgery

Design outcomes

Primary

Measure	Time frame	Description
ANI vs. SPI	Data will be assessed and collected immediately after completion of each case of surgery.	Evaluation of the ANI and comparison to SPI (same unit of measure, both ranging between 0-100, no dimension) in patients undergoing elective surgery in lithotomy position. Evaluation and change of ANI and SPI values at pre-defined timepoints: 1) Baseline, 2) before induction of anaesthesia, during 3) intubation or spinal punction, 4) posture maneuver, 5) skin incision 6) surgical suture, 7) post anesthetic care unit stay (arrival).

Countries

Germany

Outcome results