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Tytuł:
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Benefits of intraoperative analgesia guided by the Analgesia Nociception Index (ANI) in bariatric surgery: An unmatched case-control study.
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Autorzy:
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Le Gall L; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France; Univ. Bordeaux, INSERM, UMR 1034, Biology of Cardiovascular Diseases, 33600 Pessac, France.
David A; CHU Bordeaux, Department of Visceral Surgery, Magellan Medico-Surgical Center, 33000 Bordeaux, France.
Carles P; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France.
Leuillet S; Biofortis Mérieux NutriSciences, 44800 Saint-Herblain, France.
Chastel B; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France.
Fleureau C; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France.
Dewitte A; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France; Univ. Bordeaux, INSERM, UMR 1026, BioTis Tissue Bioengineering, 33000 Bordeaux, France.
Ouattara A; CHU Bordeaux, Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, 33000 Bordeaux, France; Univ. Bordeaux, INSERM, UMR 1034, Biology of Cardiovascular Diseases, 33600 Pessac, France. Electronic address: .
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Źródło:
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Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2019 Feb; Vol. 38 (1), pp. 35-39. Date of Electronic Publication: 2017 Oct 12.
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Typ publikacji:
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Journal Article; Observational Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: Issy-les-Moulineaux cedex, France : Published by Elsevier Masson SAS on behalf of the Société française d'anesthésie et de réanimation (Sfar), [2015]-
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MeSH Terms:
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Bariatric Surgery*
Nociception*
Obesity*/physiopathology
Obesity*/surgery
Analgesia/*methods
Analgesics, Opioid/*administration & dosage
Sufentanil/*administration & dosage
Adult ; Analgesics, Opioid/adverse effects ; Body Mass Index ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Morphine/administration & dosage ; Nausea/chemically induced ; Pain Measurement ; Respiratory Distress Syndrome/chemically induced ; Sufentanil/adverse effects ; Time Factors ; Vomiting/chemically induced
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Contributed Indexing:
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Keywords: Analgesia; Analgesia nociception index; Bariatric surgery; Monitoring; Obesity
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Substance Nomenclature:
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0 (Analgesics, Opioid)
76I7G6D29C (Morphine)
AFE2YW0IIZ (Sufentanil)
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Entry Date(s):
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Date Created: 20171017 Date Completed: 20200402 Latest Revision: 20220330
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Update Code:
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20240105
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DOI:
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10.1016/j.accpm.2017.09.004
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PMID:
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29033356
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Introduction: Analgesia Nociception Index (ANI) has been proposed for the evaluation of the nociception-antinociception balance in the perioperative period. In obese patients, where the management of analgesia may be rendered difficult by pharmacological changes, we hypothesised that the monitoring of analgesia with ANI would reduce intraoperative opioid consumption during bariatric surgery.
Methods: This monocentric, observational, unmatched case-control study aimed to compare perioperative data from obese subjects (body mass index ≥35kgm -2 ) during bariatric surgery with or without the use of ANI monitoring (ANI+ group versus ANI- group). Intraoperative analgesia was provided by injection of sufentanil, which was performed according to the clinician's assessment in the ANI- group or to the ANI value in the ANI+ group. The primary outcome was the mean hourly intraoperative sufentanil requirement. Secondary outcomes included the need for postoperative morphine titration, incidence of nausea and vomiting, respiratory distress and pain scores in the first 24hours.
Results: Between December 2013 and September 2016, 60 obese patients (i.e. 30 per group) were included. The mean hourly consumption of sufentanil was significantly lower in the ANI+ group (0.15±0.05μgkg -1 h -1 versus 0.17±0.05μgkg -1 h -1 , P=0.038). We found no difference between groups regarding the incidence of nausea and vomiting, acute respiratory distress, the need for postoperative morphine titration, or pain scores in the first 24 postoperative hours.
Conclusion: The use of ANI monitoring might reduce intraoperative consumption of sufentanil during bariatric surgery but does not appear to be accompanied by a reduction in its side effects.
(Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)
