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Effects of indexes of consciousness (IoC1 and IoC2) monitoring on remifentanil dosage in modified radical mastectomy: a randomized trial
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Effects of indexes of consciousness (IoC1 and IoC2) monitoring on remifentanil dosage in modified radical mastectomy: a randomized trial
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Effects of indexes of consciousness (IoC1 and IoC2) monitoring on remifentanil dosage in modified radical mastectomy: a randomized trial
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Journal Article
Effects of indexes of consciousness (IoC1 and IoC2) monitoring on remifentanil dosage in modified radical mastectomy: a randomized trial
2016
Overview
Background
This study investigated the effects of indexes of consciousness (IoC1 and IoC2) monitoring on remifentanil dosage.
Methods
In this randomized, single-blinded, prospective study, 120 patients undergoing unilateral modified radical mastectomy were randomly assigned to the treatment group (T group,
n
= 60) or control group (C group,
n
= 60). In the T group, patients received both IoC1 (sedation) and IoC2 (analgesia) monitoring, and remifentanil dosages were adjusted by anesthetists according to IoC2. In the C group, remifentanil dosages were adjusted based on the anesthetists’ judgment according to the patients’ vital signs. Remifentanil dose, adjustment frequency, infusion duration, intraoperative adverse events, and quality of anesthetic recovery were compared between the two groups. The primary outcome was the dose of remifentanil.
Results
Compared with the C group, mean remifentanil dosage was significantly higher in the T group (3.8 ± 1.9 versus 3.2 ± 1.2 μg kg
-1
h
-1
,
P
< 0.05) during the anesthetic period, as was the adjustment frequency of target-controlled infusion (2.9 ± 1.9 versus 2.0 ± 1.2 times/surgery,
P
< 0.05), but there was no difference in infusion duration. Voluntary eye opening, extubation time, and recovery score were not significantly different between the two groups (
P
> 0.05). Total adverse events were significantly reduced in the T group (
P
< 0.05).
Conclusions
IoC1-targeted propofol dosing does not seem to be significantly different to hemodynamic-based monitoring, whereas IoC2 monitoring can increase remifentanil dosage during modified radical mastectomy, but the anesthetic process is more controllable and total adverse events are reduced, which improves the controllability of anesthesia.
Trial registration
Trial registration number:
ChiCTR-TRC-13004101
, registered on 27 November 2013.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V
Subject
/ Analgesics, Opioid - administration & dosage
/ Analgesics, Opioid - adverse effects
/ Analysis
/ Central nervous system agents
/ China
/ Complications and side effects
/ Consciousness - drug effects
/ Female
/ Humans
/ Mastectomy, Modified Radical - adverse effects
/ Medicine
/ Monitoring, Intraoperative - methods
/ Pain, Postoperative - diagnosis
/ Pain, Postoperative - etiology
/ Pain, Postoperative - prevention & control
/ Patients
/ Piperidines - administration & dosage
/ Piperidines - adverse effects
/ Propofol - administration & dosage
/ Statistics for Life Sciences
/ Surgery
