Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia A randomized controlled trial

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Abstract

Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n=23) or a control group (conventional analgesia group, n=22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients' characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5±2.4 vs 5.1±2.4mg; P=0.012). Extubation time was significantly shorter in the SPI group (10.6±3.5 vs 13.4±4.6 min; P=0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy.

Original languageEnglish
Article numbere4743
JournalMedicine (United States)
Volume95
Issue number35
DOIs
Publication statusPublished - 2016 Jan 1

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Oxycodone
Analgesia
Anesthesia
Randomized Controlled Trials
Thyroidectomy
Control Groups
Hemodynamics
Sufentanil
Fentanyl
Postoperative Pain
sevoflurane
Tachycardia
General Anesthesia
Opioid Analgesics
Analgesics
Hypertension
Pain

Keywords

  • Analgesia
  • General anesthesia
  • Inhalation anesthetics
  • Oxycodone
  • Photoplethysmography
  • Pulse oximetry
  • Sevoflurane

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{eb54d85e5f3441cdbb7e6b947494e1d0,
title = "Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia A randomized controlled trial",
abstract = "Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n=23) or a control group (conventional analgesia group, n=22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients' characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5±2.4 vs 5.1±2.4mg; P=0.012). Extubation time was significantly shorter in the SPI group (10.6±3.5 vs 13.4±4.6 min; P=0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy.",
keywords = "Analgesia, General anesthesia, Inhalation anesthetics, Oxycodone, Photoplethysmography, Pulse oximetry, Sevoflurane",
author = "won, {young ju} and Lim, {Byung Gun} and Lee, {So Hyun} and Sangwoo Park and Heezoo Kim and Lee, {Il Ok} and Myounghoon Kong",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/MD.0000000000004743",
language = "English",
volume = "95",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "35",

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TY - JOUR

T1 - Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia A randomized controlled trial

AU - won, young ju

AU - Lim, Byung Gun

AU - Lee, So Hyun

AU - Park, Sangwoo

AU - Kim, Heezoo

AU - Lee, Il Ok

AU - Kong, Myounghoon

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n=23) or a control group (conventional analgesia group, n=22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients' characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5±2.4 vs 5.1±2.4mg; P=0.012). Extubation time was significantly shorter in the SPI group (10.6±3.5 vs 13.4±4.6 min; P=0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy.

AB - Background: The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy. Methods: Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n=23) or a control group (conventional analgesia group, n=22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores. Results: Patients' characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5±2.4 vs 5.1±2.4mg; P=0.012). Extubation time was significantly shorter in the SPI group (10.6±3.5 vs 13.4±4.6 min; P=0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit. Conclusions: SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy.

KW - Analgesia

KW - General anesthesia

KW - Inhalation anesthetics

KW - Oxycodone

KW - Photoplethysmography

KW - Pulse oximetry

KW - Sevoflurane

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VL - 95

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

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