General Anesthesia
Conditions
Brief summary
Analgesia Nociception Index（ANI）which is derived from heart rate variability can be used to detect noxious stimulation during propofol while changing remifentanil concentrations. The aim of this study is to verify the effectiveness of ANI predictability for actual surgical noxious stimuli while satisfying the individual analgesic status by pre-tetanus-induced ANI determination during sevoflurane while changing remifentanil concentrations.
Detailed description
General anesthesia with sevoflurane and remifentanil is widely used in minor surgeries. Monitoring noxious stimulation during general anesthesia is still worth further studies and reaching clinical consensus. Analgesia Nociception Index can be used to detect noxious stimulation during propofol while changing remifentanil concentrations. Previous studies suggest that an ANI≥50 can be useful in detecting sufficient analgesia for patients who cannot self-report pain. The aim of this study is to verify the effectiveness of ANI predictability for actual surgical noxious stimuli while satisfying the individual analgesic status by pre-tetanus-induced ANI determination during sevoflurane while changing remifentanil concentrations.
Interventions
DEVICETetanic stimulation
For each participant, record the first concentration that ANI≥50 after the tetanic stimuli, as the sufficient concentration.
PROCEDURESkin incision
Infuse the sufficient concentration for at least 5min of the steady-state period, then surgical stimulus is applied. The surgical stimulus is defined as the first skin incision to establish pneumoperitoneum.
Sponsors
Beijing Chao Yang Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18- 65 years * ASA physical status I or II * Elective surgery in general anesthesia planned * Written informed consent
Exclusion criteria
* Use of CNS-active medication or abuse of alcohol * Presents of any neuromuscular or neurologic disease * History of cardiac arrhythmia * Pregnancy or using a pacemaker
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To verify the effectiveness of ANI predictability for actual surgical noxious stimuli while satisfying the individual analgesic status by pre-tetanus-induced ANI determination. | Change from Baseline ANI that 2 minutes after applied tetanic stilumation | Tetanic stimulations are applied at different effect site concentrations of remifentanil under sevoflurane anesthesia. ANI is range from 0-100. Bigger number means better analgesic level. ANI≥50 is considered to be under adequate analgesia. Tetanic stimulation is a standard tester of nociceptive stimulus. The number of ANI will fall down if the patient is feeling pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The ANI predictability for tetanic noxious stimuli | Change from Baseline Systolic Blood Pressure that 2 minutes after applied tetanic stilumation | ANI is range from 0-100. Bigger number means better analgesic level. ANI≥50 is considered to be under adequate analgesia. The number of ANI will fall down if the patient is feeling pain. |
| The heart rate predictability for tetanic noxious stimuli | Change from Baseline Heart Rate that 2 minutes after applied tetanic stilumation | Heart Rate will go up if patient is feeling pain. |
| The Bispectral Index predictability for tetanic noxious stimuli | Change from Baseline Bispectral Index that 2 minutes after applied tetanic stilumation | Bispectral Index will go up if patient is feeling pain. |
Countries
China
Outcome results
None listed