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Open Access 01-12-2018 | Research

Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial

Authors: Minqiang Liu, Hongyan Wu, Danling Yang, Fengxian Li, Zhichao Li, Song Wang, Renliang He

Published in: Trials | Issue 1/2018

Abstract

Background

With the development of painless diagnosis and treatment, remifentanil, a synthetic opioid agonist, is increasingly used in gastroscopy for its rapid, short-term, and potent analgesic effect. However, the dosage of remifentanil used in endoscopy is unclear. Index of consciousness (IOC) is a new anesthesia depth-monitoring indicator that can be divided into index of consciousness 1 (IOC₁) and index of consciousness 2 (IOC₂); IOC₁ is used for estimating a patient’s sedation state, whereas IOC₂ reflects analgesic depth. We hypothesized that combining with IOC₁ and IOC₂ monitoring may be helpful to identify an optimal remifentanil dosage in gastroscopic polypectomy.

Methods

One hundred twenty patients scheduled for gastroscopic polypectomy were enrolled and were randomly assigned to remifentanil 2 ng/mL (group R2), 4 ng/mL (group R4), or 6 ng/mL (group R6), and 40 cases were in each group. During the anesthesia period, remifentanil was kept at the initial given concentration but propofol was adjusted according to IOC₁. The primary outcomes were the dosage of propofol and remifentanil. The secondary outcomes were the variety of IOC₁ and IOC₂, patients’ awakening time, and peri-operative adverse reactions such as hypotension, hypertension, bradycardia, tachycardia, body movements, hypoxemia, therapy interruption, nausea, vomiting, aspiration, and intra-operative awareness.

Results

With the increasing dosage of remifentanil, the propofol dosage and patients’ awakening time decreased significantly, the morbidity of hypertension and body movements also declined, but the incidence of hypotension, bradycardia, and hypoxemia rose. In group R2, the value of IOC₂ remained above 50 during the treatment. However, IOC₂ dropped to below 30 at the beginning of the gastroscopy in group R6, and there was statistical difference in hypoxemia between groups R2 and R6 (P <0.05).

Conclusions

With the help of IOC monitoring, we found that a target concentration of remifentanil 4 ng/mL is comparatively ideal in patients under gastroscopic polypectomy.

Trial registration

Chinese Clinical Trial Register: ChiCTR-OOD-16009489, on October 19, 2016.

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Title: Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial
Authors: Minqiang Liu
Hongyan Wu
Danling Yang
Fengxian Li
Zhichao Li
Song Wang
Renliang He
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-018-2783-4

ACC 2024 Congress

Springer Medicine

Effects of small-dose remifentanil combined with index of consciousness monitoring on gastroscopic polypectomy: a prospective, randomized, single-blinded trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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