The Prediction for Postoperative Pain
Study Details
Study Description
Brief Summary
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 degree of pain during surgery and the amount of analgesic use for management of postoperative pain.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Post-operative pain not only alleviates patient discomfort, but also delays recovery and thus prolongs the hospital stay. There are many ways to control postoperative pain, but analgesic infusion through venous route, patient controlled analgesia (PCA), especially narcotic analgesics, is often used to control the infusion when needed. However, because PCA is based on only age, weight, and underlying diseases, there are limitations in effective analgesia, and excessive sedation due to excessive infusion. Therefore, 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. The noxious stimuli during surgery may have a negative effect on the healing process and surgical outcome of the wound due to stress reaction and catabolism, secretion of pituitary hormone, activation of the sympathetic nervous system, and immunological changes. Therefore, proper analgesia is needed during general anesthesia. A non-invasive, non-invasive analgesic device is currently available for Surgical pleth index (SPI) to assess the status of intraoperative analgesia. 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 the postoperative pain prediction study with SPI, the SPI value at the end of the operation was found to be proportional to the pain in the recovery room. However, only the pain score immediately after the operation was confirmed in these studies. Therefore, investigators try to evaluate the degree of pain during surgery and the amount of analgesic use for management of postoperative pain.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: SPI Group All patients who received the liver resection surgery will receive surgical pleth index |
Device: surgical pleth index
All patients applied surgical pleth index after recovery of spontaneous breathing at the time of peritoneum and skin closure under Bispectral index score <=60.
|
Outcome Measures
Primary Outcome Measures
- The correlation of requirement of postoperative analgesics for postoperative 24 hours and intraoperative nociception score [intraoperative nociception score: 3 minutes during closure peritoneum and skin; requirement of postoperative analgesics: the first 24 hour in postoperative phase]
The consumption of patient controlled analgesia and intraoperative surgical pleth index score
Secondary Outcome Measures
- The correlation of requirement of postoperative analgesics for postoperative 6 hours and intraoperative nociception score [intraoperative nociception score: 3 minutes during closure peritoneum and skin; requirement of postoperative analgesics: the first 6 hour in postoperative phase]
The consumption of patient controlled analgesia and intraoperative surgical pleth index score
- The correlation of requirement of postoperative analgesics for postoperative 48 hours and intraoperative nociception score [intraoperative nociception score: 3 minutes during closure peritoneum and skin; requirement of postoperative analgesics: the first 48 hour in postoperative phase]
The consumption of patient controlled analgesia and intraoperative surgical pleth index score
- The correlation of postoperative pain score and intraoperative nociception score [awaken after general anesthesia in post-anesthesia care unit , postoperative 6, 24, 48 hours]
The postoperative pain score (numeric rating pain score, no pain=0~ worst pain=10)and intraoperative surgical pleth index score
- The side effects of analgesics [awaken after general anesthesia in post-anesthesia care unit , postoperative 6, 24, 48 hours]
nausea/vomiting, sedation, itching, respiratory depression
Eligibility Criteria
Criteria
Inclusion Criteria:
undergoing liver resection (laparoscopic or laparotomy)
Exclusion Criteria:
patients who refused to participate patients who have cardiac arrythmia patients who have allergic history for remifentanil
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Samsung medical center | Seoul | Korea, Republic of | 06351 |
Sponsors and Collaborators
- Samsung Medical Center
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Dolin SJ, Cashman JN. Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidence from published data. Br J Anaesth. 2005 Nov;95(5):584-91. Epub 2005 Sep 16. Review.
- Ledowski T, Burke J, Hruby J. Surgical pleth index: prediction of postoperative pain and influence of arousal. Br J Anaesth. 2016 Sep;117(3):371-4. doi: 10.1093/bja/aew226.
- Ledowski T, Sommerfield D, Slevin L, Conrad J, von Ungern-Sternberg BS. Surgical pleth index: prediction of postoperative pain in children? Br J Anaesth. 2017 Nov 1;119(5):979-983. doi: 10.1093/bja/aex300.
- SMC2018-04-129