Anesthesia Clinical Trial
Official title:
Does Administration of Dexmedetomidine Guided by Entropy/SPI Reduce the Requirement of Propofol and Remifentanil as Well as Increase the Quality of Recovery Profile?
Dexmedetomidine, a selective alpha2-adrenergic agonist is known to reduce propofol and opioid requirements due to its sedative and analgesic properties. However, until now, there has been studies based on indirect measures such as hemodynamics. Entropy shows to quantify the level of consciousness by EEG and Surgical pleth index(SPI) allows to predict the effect of pain stimuli and analgesic therapy by the index of the nociception-anti-nociception balance. The investigators analyzed quantitatively the requirements of propofol and remifentanil under continuous infusion of dexmedetomidine when using entropy and SPI.
Dexmedetomidine, a selective alpha2-adrenergic agonist is known to reduce propofol and
opioid requirements due to its sedative and analgesic properties. However, until now, there
has been studies based on indirect measures such as hemodynamics. Entropy shows to quantify
the level of consciousness by EEG and Surgical pleth index(SPI) allows to predict the effect
of pain stimuli and analgesic therapy by the index of the nociception-anti-nociception
balance. The investigators analyzed quantitatively the requirements of propofol and
remifentanil under continuous infusion of dexmedetomidine when using entropy and SPI.
Patients (20~65 years old, ASA class 1 or 2) scheduled lumbar discectomy under general
anesthesia were recruited. The patients were randomly allocated to two groups. Both groups
received Target controlled infusion(TCI) of propofol and remifentanil and the
dexmedetomidine was added to the Dex group and normal saline was added to the Placebo group.
The Dex group received 1mcg/kg loading dose followed by 0.5mcg/kg/hr infusion of
dexmedetomidine which was administered at induction of anesthesia through skin closure. The
placebo group received equal amount of normal saline. During maintenance of anesthesia the
effect site concentration of propofol and remifentanil was titrated to maintain Entropy(SE)
40~60 and SPI under 50. Blood pressure and heart rate also was measured. The total amount of
propofol and remifentanil administered, time between eye opening and extubation was
recorded. The quality of recovery was evaluated by QoR-40 survey after 24 hours postop.
;
Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Prevention
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