This is a unicentric, prospective randomised trial that aims to evaluate the role of intra-operative monitoring of nociception through SPI (Surgical Pleth Index) in guiding analgesia and reducing opioid consumption in obese patients undergoing bariatric surgery. We aim to enrol 40 patients having laparoscopic gastric sleeve surgery in the Cluj-Napoca County Hospital. They will be randomised into two groups, one with opioid administration during surgery guided by SPI, and the other one guided by anesthetist experience. We will monitor opioid consumption, pain scores during the first 90 minutes post-operatively, hemodinamic events during surgery and the duration between reversal of neuromuscular block and extubation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
40
In the SPI-guided group, when SPI is higher than 50 for the first time and for more than 3 minutes, we will administer 1,0 μg/kg of fentanyl LBW. When SPI is again higher than 50 and for more than 5 minutes, we will re-administer 1,0 μg/kg of fentanyl LBW. We will repeat until SPI is between 20-50.
First Surgical Clinic, County Hospital
Cluj-Napoca, Romania
RECRUITINGPain scores on the visual analog scale during the first 90 minutes post-operatively
Pain scores on the visual analog scale during the first 90 minutes post-operatively
Time frame: during the first 90 minutes post-operatively
Opioid consumption
the amount of fentanyl per LBW
Time frame: during surgery
Sevoflurane concentration
mean MAC and sevoflurane concentration during surgery
Time frame: during surgery
Time from neuromuscular reversal to extubation
Time from neuromuscular reversal to extubation
Time frame: at the end of surgery
Hemodinamic events
an increase in heart rate or mean arterial pressure with more than 20% of the basal values (measured on the ward)
Time frame: during surgery
Rescue analgesia
the need for rescue opioids during the first 90 minutes post-operatively
Time frame: in the first 90 minutes post-operatively
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