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Published in: Journal of Clinical Monitoring and Computing 3/2020

01-06-2020 | General Anesthesia | Original Research

Association between intraoperative nociception and postoperative complications in patients undergoing laparoscopic gastrointestinal surgery

Authors: Hiroki Ogata, Shiroh Nakamoto, Hiroki Miyawaki, Ryusuke Ueki, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose

Published in: Journal of Clinical Monitoring and Computing | Issue 3/2020

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Abstract

A higher degree of surgical invasiveness, which increases intraoperative nociception, might induce postoperative complications. Although several nociceptive indices for use during surgery are available in clinical practice, association between intraoperative nociception and postoperative complications has not been reported. An index representing intraoperative nociception, which is the averaged value of Nociceptive Response throughout the surgery (mean NR) was applied to examine the association in the present study. The retrospective study evaluated consecutive adult patients undergoing laparoscopic gastrointestinal surgery, American Society of Anesthesiologists–physical status (ASA-PS) I or II, whose preoperative C-reactive protein level was < 0.3 mg dL−1. We first used ordinal logistic analysis to examine the association between preoperative and intraoperative risk factors and complications graded by the Clavien-Dindo classification. Next, we performed propensity score matched analysis to evaluate the effects of mean NR throughout surgery on postoperative complications. Ordinal logistic analysis (n = 158) revealed that duration of surgery (P < 0.001), mean NR during surgery (P = 0.002), and ASA-PS (P = 0.016) were risk factors for postoperative complications. Then all patients were divided into two propensity score matched groups, based on a mean NR of < 0.85 and ≥ 0.85, with matching for age, ASA-PS, body mass index and duration of surgery. The severity of postoperative complications was significantly higher in the high NR group than in the low NR group (P = 0.005). In conclusion, there was likely an association between intraoperative nociception and postoperative complications in patients without serious preoperative conditions and comorbidities.
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Metadata
Title
Association between intraoperative nociception and postoperative complications in patients undergoing laparoscopic gastrointestinal surgery
Authors
Hiroki Ogata
Shiroh Nakamoto
Hiroki Miyawaki
Ryusuke Ueki
Nobutaka Kariya
Tsuneo Tatara
Munetaka Hirose
Publication date
01-06-2020
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 3/2020
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-019-00347-3

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