Randomized controlled trial of the effect of depth of anaesthesia on postoperative pain

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dc.contributor.author Law, CJ en
dc.contributor.author Jacobson, GM en
dc.contributor.author Kluger, M en
dc.contributor.author Chaddock, M en
dc.contributor.author Scott, M en
dc.contributor.author Sleigh, James en
dc.coverage.spatial England en
dc.date.accessioned 2017-02-24T02:00:55Z en
dc.date.available 2013-08-22 en
dc.date.issued 2014-04 en
dc.identifier.citation British Journal of Anaesthesia, April 2014, 112 (4), 675 - 680 en
dc.identifier.issn 0007-0912 en
dc.identifier.uri http://hdl.handle.net/2292/31958 en
dc.description.abstract BACKGROUND: Our hypothesis was that deep anaesthesia, as estimated by a low target bispectral index (BIS) of 30-40, would result in less postoperative pain than that achieved at a conventional depth of anaesthesia. METHODS: We undertook a randomized double-blind controlled study at two tertiary teaching hospitals in New Zealand (2010-1) recruiting 135 adult patients ASA I-II presenting for non-emergent surgery under general anaesthesia requiring tracheal intubation. Anaesthesia was maintained with desflurane and a multimodal analgesia regimen comprising fentanyl infusion, i.v. paracetamol, and parecoxib. Patients were randomly assigned to either a low BIS (30-40) group or a high BIS (45-60) group. Desflurane concentrations were titrated to achieve these targets. Postoperative pain was assessed by: the pain on awakening (0-10, verbal rating scale, VRS(awake)) in the post-anaesthetic care unit; pain on activity at 20-24 h after operation (VRS(d1A)); and the rate of morphine patient-controlled analgesia (PCA) usage over the first 24 h. RESULTS: There was no statistically significant difference between the two groups for any of the pain scores. The median [inter-quartile range (IQR)] VRS(awake) was 4.0 (0-8) for the low and 4.0 (0-8) for the high BIS groups (P=0.56). The median (IQR) VRS(d1A) was 3.0 (1-5) for the low and 3.0 (1.5-4.5) for the high BIS groups (P=0.83). The median PCA morphine consumption in the low BIS group was 0.61 mg h(-1) (0.04-1.5) vs 0.43 mg h(-1) (0-1.59) in the high BIS group (P=0.98). CONCLUSIONS: We conclude that there is no clinically useful analgesic effect of a deep anaesthesia regimen. en
dc.description.uri https://www.ncbi.nlm.nih.gov/pubmed/24322572 en
dc.language English en
dc.publisher Oxford University Press en
dc.relation.ispartofseries British Journal of Anaesthesia en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/0007-0912/ https://academic.oup.com/journals/pages/access_purchase/rights_and_permissions/self_archiving_policy_b en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject depth of anaesthesia en
dc.subject postoperative pain en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Analgesia, Patient-Controlled en
dc.subject Analgesics, Opioid en
dc.subject Anesthesia, General en
dc.subject Anesthetics, Inhalation en
dc.subject Double-Blind Method en
dc.subject Drug Administration Schedule en
dc.subject Electroencephalography en
dc.subject Female en
dc.subject Fentanyl en
dc.subject Humans en
dc.subject Isoflurane en
dc.subject Male en
dc.subject Middle Aged en
dc.subject Monitoring, Intraoperative en
dc.subject Morphine en
dc.subject Pain Measurement en
dc.subject Pain, Postoperative en
dc.subject Young Adult en
dc.title Randomized controlled trial of the effect of depth of anaesthesia on postoperative pain en
dc.type Journal Article en
dc.identifier.doi 10.1093/bja/aet419 en
pubs.issue 4 en
pubs.begin-page 675 en
pubs.volume 112 en
dc.description.version VoR - Version of Record en
dc.identifier.pmid 24322572 en
pubs.author-url https://academic.oup.com/bja/article-lookup/doi/10.1093/bja/aet419 en
pubs.end-page 680 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 420715 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Anaesthesiology en
dc.identifier.eissn 1471-6771 en
dc.identifier.pii aet419 en
pubs.record-created-at-source-date 2017-02-24 en
pubs.online-publication-date 2013-12-08 en
pubs.dimensions-id 24322572 en

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