Pain, Postoperative Clinical Trial
Official title:
Can we Predict Postoperative Analgesic Requirement by Intraoperative Nociception?
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.
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.
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