The purpose of this study is to determine whether Analgesia Nociception Index (ANI) can effectively reduce the dose of opioid in patients who underwent general anesthesia using remimazolam.
Study Type
OBSERVATIONAL
Enrollment
30
The purpose of this study is to determine the validity of ANI in patients undergoing surgery with remifentanil and remimazolam. During this study, remimazolam infusion rate is determined by the pharmacopoeia. Remifentanil infusion rate is determined based on the patient's vital signs, systemic status and pain levels. And remifentanil is administrated via targeted infusion control using the Minto model. ANI scores, vital signs, remifentanil infusion rate are collected at predetermined time points according to the protocol from the start to the end of the surgery.
Catholic-Kwandong University, School of Medicine
Incheon, South Korea
RECRUITINGANI values
A value indicating the degree of pain calculated by ANI's algorithm
Time frame: During Surgery (at the points of intubation, skin incision, CO2 insufflation, TOF stimulation, and hemodynamic change)
Heart Rate (HR) change
Because the ANI value is calculated using the change in HR, it is measured to correlate the change in ANI value with the change in HR due to pain.
Time frame: Every 2 seconds for 2.5 minutes before and Every 2 seconds for 2.5 minutes after pain stimulation
Patient state index (PSI) change
The PSI is an indicator of a patient's depth of sedation and is calculated based on EEG, which can change in response to painful stimuli. The PSI score is expressed as a number between 0 and 100, and it is usually recommended to maintain under 60 during surgery. An increase in the PSI score can indicates the degree of pain stimulus and can be used as an indicator to assess the validity of the ANI value.
Time frame: Every 2 seconds for 2.5 minutes before and Every 2 seconds for 2.5 minutes after pain stimulation
Blood Pressure change
When a patient feels pain, it stimulates the autonomic nervous system to change blood pressure. This change is measured to determine how much pain the patient is feeling
Time frame: Every 2 seconds for 2.5 minutes before and Every 2 seconds for 2.5 minutes after pain stimulation
Remimazolam infusion rate
Remimazolam is a sedative. The infusion rate of remimazolam correlates with sedation level. And it is measured to determine if sedation level correlates with ANI values when pain stimuli are given.
Time frame: During Surgery (at the points of intubation, skin incision, CO2 insufflation, TOF stimulation, and hemodynamic change)
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Effect site concentration of remifentanil
Remifentanil is an opioid and can affect pain levels when given a pain stimulus.
Time frame: During Surgery (at the points of intubation, skin incision, CO2 insufflation, TOF stimulation, and hemodynamic change)