Anaesthesia
Conditions
Interventions
Hemodynamic Guided Analgesia
ANI Guided Analgesia
Sponsors
national liver institute
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: • Adult patients aged 18- 75 years of both sexes. • ASA physical status I–III. • BMI <35 kg/m². • Patients scheduled for elective hepatobiliary surgery under general anesthesia • Duration of surgery 2-4 hours. • Ability to understand and provide informed consent.
Exclusion criteria
Exclusion criteria: • Patient refusal. • Cardiac arrhythmias interfering with ANI (e.g., atrial fibrillation) (9) • Pacemaker dependency (9) • Chronic opioid use (>3 months daily opioid use or opioid tolerance) (10) • Severe hepatic or renal failure (Child C or eGFR 35 kg/m² (if concerned for reliable ANI signal) (13) • Use of medications affecting autonomic balance within 24 h (e.g. high beta-blockers and anticholinergic drugs) • Pregnancy • Known allergy to study drugs
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| total intraoperative opioid consumption (in µg fentanyl equivalents) between the ANI-guided analgesia group and the hemodynamic-guided group. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To compare intraoperative hemodynamic stability (episodes of hypotension/bradycardia, hypertension/tachycardia), and vasoactive drug usage between groups. 2. To assess postoperative pain by (VAS) score . 3. To compare postoperative opioid consumption (nalbuphine equivalents) within 24 h. 4. To assess time to extubation, time to PACU discharge, incidence of PONV (post-operative nausea and vomiting) and sedation score at PACU. 5. To evaluate adverse events related to analgesic management (respiratory depression, over-sedation, hemodynamic instability). | — |
Countries
Egypt
Contacts
Public Contacthanaa rashed
anasthesia lecturer
Outcome results
None listed