anesthesie/chirurgie anesthesia narcosis
Conditions
Interventions
None listed
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age: 18-80 years; 2. ASA I-II-III 3. Elective open abdominal surgery or laparoscopic assisted abdominal surgery.
Exclusion criteria
Exclusion criteria: 1. Unable to give written informed consent; 2. Use of epidural analgesia or local anesthesia (eg. transversus abdominal plain block, TAP block) 3. Non-elective surgery 4. Pregnancy/lactation; 5. BMI > 35 kg/m2; 6. Uncontrolled preoperative hypo- or hypertension (Mean arterial pressure 100 mmHg) 7. Preoperative Heart rate 90/min; 8. Central nervous system disorder (neurologic/head trauma/uncontrolled epileptic seizures); 9. Illicit substance or alcohol abuse within 30 days; 10. Chronic use of pain medication within 30 days; 11. Chronic use of psychoactive drugs within 30 days; 12. Significant medical condition a. Untreated or persistent peripheral or central cardiovascular disease b. Severe pulmonary disease e.g. COPD gold 4 , FEV 6.0 kPa c. Significant hepatic disease with increased bilirubin, INR or low albumin 13. Beta blocker use
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Opioid and propofol consumption in total dose and dose/min; and 2. Incidence (number of episodes) and total duration of inadequate anesthesia (as derived from heart rate, blood pressure, BIS values and somatic arousal) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Differences in Pk (prediction probability) values of NoL, BIS, HR and MAP for predicting the balance of nociception-anti nociception during the following states • Awake vs. loss of consiousness (LOC) • Anesthesia (after discontinuation of propofol and remifentanil) vs. opening eyes • LOC vs intubation • Normal stimulation vs maximum stimulation (as indicated by the surgeon); 2. Incidence of NoL values 20; 3. Time from reversal of neuromuscular blockade to extubation; 4. Pain and sedation scores, incidence of nausea/vomiting, hemodynamics, respiration and medication use (e.g. opioids and antiemetics) in the recovery room obtained at 15-min interval; 5. PACU: time until Aldrete > 9 (readiness for discharge); 6. Incidence of memory/awareness. | — |
Countries
Netherlands