Investigators will examaine the effects of Analgesia Nociception Index (ANI)-guided analgesia on postoperative bowel function recovery in laparoscopic colorectal surgery. This is a prospective randomized-controlled study. Investigators will randomly divide the patients into two groups. In ANI group, remifentanil infusion rate during anesthesia will be adjusted according to ANI monitoring. In Control group, remifentanil infusion rate during anesthesia will be adjusted according to the conventional method of blood pressure and heart rate monitroing. And Investigators will evalualte the bowel function recovery in both groups after surgery, and compare between the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
80
Investigators will attach the ANI monitor V2 (MDoloris Medical Systems, Lille, France) to the patient and monitor Analgesia Nociception Index (ANI) during anesthesia. Remifentanil infusion rate is adjusted according to ANI monitoring. The ANI is adjusted to be between 50 and 70.
Remifentanil infusion rate is adjusted according to the conventional method of blood pressure and heart rate monitroing. Blood pressure and heart rate are controlled to be within 20% of baseline. Investigators will not monitor ANI in this group.
GangnamSeverance Hospital
Seoul, South Korea
RECRUITINGTime to first gas passing from surgery
Time (hours) to first gas passing from surgery
Time frame: Up to postoperative 2weeks
Time to starting fluid intake from surgery
Time (hours) to starting oral fluid intake after surgery
Time frame: up to 2weeks
Time to starting soft diet from surgery
Time (hours) to starting soft diet from surgery
Time frame: up to 2 weeks
Intraoperative opioid consumption
Total opioid dose administered to the patient during anesthesia
Time frame: during anesthesia
Postoperative opioid consumption
Total opioid dose administered to the patient after surgery.
Time frame: postoperative 6hours, 12hours, 24hours, 36hours, 48hours, 3days, 4days, 5days.(Minimum value: 0, Maximum value: 10, higher score means worse.)
Pain score
Visual analog scale (VAS) 0-10
Time frame: postoperative 6hours, 12hours, 24hours, 36hours, 48hours, 3days, 4days, 5days.(Minimum value: 0, Maximum value: 10, higher score means worse.)
Nausea score
verbal numerical rating scale 0-10
Time frame: postoperative 6hours, 12hours, 24hours, 36hours, 48hours, 3days, 4days, 5days
Time to first rescue analgesics from surgery
Time (hours) to first rescue analgesics from surgery.
Time frame: up to 2weeks
Number of vomiting, antiemetic administration
Number of vomiting, antiemetic administration
Time frame: up to 2weeks
Time to starting ambulation from surgery.
Time (hours) to starting ambulation from surgery
Time frame: up to 2 weeks
QoR-15
Score of QoR-15 questionnaire (Quality of Recovery-15) (Minimum value: 0, Maximum value: 150, higher score means better.)
Time frame: postoperative 1days, 4days
Hemodynamics during anesthesia
hemodynamics (blood pressure, heart rate) during anesthesia
Time frame: during anesthesia
Plasma concentration of Cortisol, Norepinephrine, Epinephrine, IL-6
Plasma concentration of Cortisol(mcg/dL), Norepinephrine(pg/mL), Epinephrine(pg/mL), IL-6(pg/mL) immediately after surgery
Time frame: immediately after surgery
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