An observational study in Pain, Postoperative, Nociceptive Pain and Analgesics, sponsored by Samsung Medical Center. Completed at 1 site in South Korea. Open to participants aged 20 Years to 80 Years. Per ClinicalTrials.gov, last updated 2019-07-12.
Sponsored by Samsung Medical Center · Observational
If the individual patient's pain is assessed and the amount of analgesic needed after surgery is predicted, appropriate injection of pain control and excessive injection of narcotic analgesic can be prevented. Therefore, investigators try to evaluate the relation intraoperative nociception response with postoperative pain score.
In similar anesthetic depth(End tidal sevoflurane 3%) , changes of surgical pleth index values for stimulus of skin incision are thought to reflect the individual nociception characteristics.
Patients who undergoing upper abdominal laparotomy surgery usually experience severe postoperative pain. Previous studies were reported that preoperative pain, young age, high-dose remifentanil, and depression were associated with severe postoperative pain.
However, anesthesia-related studies were either retrospective studies or injected with anesthetic agents in excess of clinical doses to differentiate between groups. There is no objective indicator for prediction severe postoperative pain.The purpose of this study was to investigate the relationship between intraoperative pain response and postoperative pain on standardized surveillance devices.
To maintain the depth of anesthesia, an EEG monitoring device bispectral index (BIS) is used. Also, surgical pleth index (SPI, GE healthcare, Freiburg, Germany) is a noninvasive pain-analgesia balance monitoring device that is commercially available to evaluate the state of pain during general anesthesia. SPI = 100- (0.3 * heart beat interval + 0.7 * photoplethysmographic pulse wave amplitude) is automatically and continuously calculated from the waveform of peripheral oxygen saturation.
In similar anesthetic depth(End tidal sevoflurane 3%) , changes of SPI values for stimulus of skin incision are thought to reflect the individual nociception characteristics. The investigators hypothesized the higher analgesics consumption can predict with high SPI response following incisional stimuli.
Thus, investigators try to evaluate the comparison of two groups ( high fentanyl consumption group vs. low fentanyl consumption group) with intraoperative SPI value (incision and before aurosal) and hemodynamic parameters under End tidal sevoflurane 3%(anesthesia depth, hemodynamically stable and appropriate anesthetic depth based on previous studies were confirmed at the time of skin incision). And the characteristics and emotional status of patients in two groups are compared.
5,227 studies on the registry are indexed under Pain, Postoperative; 1,154 are open to participants now.
This study's enrollment of 50 is below the median of 100 across 622 observational studies indexed under Pain, Postoperative.
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the 20-80 year old patients who undergoing lapatotomy gastrectomy at samsung medical center
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-undergoing laparotomy gastrectomy
Exclusion Criteria:
All patients who received the liver resection surgery will receive surgical pleth index
Device: SPI group
All patients applied surgical pleth index at the time of surgical incision, under End tidal Sevoflurane 3%
The requirement of postoperative analgesics for postoperative 24 hours
The requirement of postoperative analgesics for postoperative 24 hours (opioid conversion to fentanyl dose mcg)
Time frame: postoperative 24 hour
The immediate postoperative pain score
The numeric rating pain score, no pain=0 \~ worst pain=10
Time frame: postoperative 24 hour
intraoperative nociception score (surgical pleth index)
under End tidal sevoflurane 3%, surgical pleth index score following surgical incision
Time frame: intraoperative at the time of skin incision
The correlation of requirement of summed postoperative analgesics and intraoperative nociception score
The consumption of analgesics (opioid conversion to fentanyl dose mcg) and intraoperative surgical pleth index value
Time frame: postoperative 1 hour
The correlation of highest postoperative pain score and intraoperative nociception score
The postoperative pain score (numeric rating pain score, no pain=0\~ worst pain=10)and intraoperative surgical pleth index score
Time frame: postoperative 1 hour
The expectation of postoperative pain
The postoperative pain score (numeric rating pain score, no pain=0\~ worst pain=10)
Time frame: The day before surgery
The expectation of analgesics consumption
less than average, average, more than average
Time frame: The day before surgery
Plan to share: No
This study is completed, as verified in Nov 2018. You cannot join it, but the record below documents what was studied.
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