Dexmedetomidine Target Controlled infusion (TCI, Dyck model) effects on Neuromonitoring during Total Intravenous Anesthesia (TIVA) with Propofol and Remifentanil TCI (Eleveld model) has not been investigate yet. Authors aim to investigate its effect on Patient State index (PSi), the power spectrum EEG, the Analgesia Nociception Index (ANI) and pupillometry values during maintenance during TIVA-TCI with Propofol, Remifentanil and Dexmedetomidine.
The effects of Dexmedetomidine administered via Target-Controlled Infusion (TCI, Dyck model) on neuromonitoring during Total Intravenous Anesthesia (TIVA) with Propofol and Remifentanil (TCI, Eleveld model) have not yet been investigated. The authors aim to systematically evaluate the impact of adding Dexmedetomidine on key neuromonitoring parameters commonly used in clinical anesthesia during the maintenance phase of TIVA-TCI. Specifically, the study will assess: Patient State Index (PSi) as a measure of the hypnotic state; Electroencephalographic (EEG) power spectrum, to identify changes in cortical activity patterns associated with Dexmedetomidine administration; Analgesia Nociception Index (ANI), to evaluate potential modifications in the analgesia-nociception balance; Pupillometry, to quantify autonomic and pupillary responses to stimuli. This investigation aims to determine whether the addition of Dexmedetomidine using a TCI approach produces predictable and clinically relevant alterations in neurophysiological monitoring during anesthesia with Propofol and Remifentanil. Ultimately, the study seeks to support more precise drug titration and enhance patient safety.
Study Type
OBSERVATIONAL
Enrollment
60
Treviso Regional Hospital
Treviso, TV, Italy
RECRUITINGEffects of Dexmedetomidine on Patient State index (PSi) during stable Propofol - Remifentanil general anesthesia
Evaluate if Dexmedetomidine variations during general anesthesia has an impact on the PSi values
Time frame: PSi values and DexmedetomidineTarget Controlled Infusion (TCI) concentrations will be monitored during all the time of surgery
Effects of Dexmedetomidine on Electroencephalogram (EEG) power spectrum during stable Propofol - remifentanil general anesthesia
Evaluate if dexmedetomidine variations during general anesthesia has an impact on the EEG power spectrum
Time frame: EEG power spectrum and DexmedetomidineTarget Controlled Infusion (TCI) concentrations will be monitored during all the time of surgery
Effects of Dexmedetomidine on Analgesia Nociception Index (ANI) during stable Propofol general anesthesia
Evaluate if dxmedetomidine variations during general anesthesia has an impact on the ANI values
Time frame: ANI values and Sufentanil Target Controlled Infusion (TCI) concentrations will be monitored during all the time of surgery
Analgesia Nociception Index (ANI) values and postoperative pain
Evaluate if different ANI values at the same dexmedetomidine concentrations has an impact on postoperative pain
Time frame: Numeric Rating Scale (NRS) will be evaluated after the end of surgery and 24 hours after the end of surgery and compared to ANI values after 24 hours
Patient State Index (PSi) values and postoperative delirium
Evaluate if different PSi values at the same dexmedetomidine concentrations has an impact on postoperative delirium
Time frame: Confusion assessment method (CAM) test for delirium will be performed after the end of surgery and compared to PSi values after 24 hours
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