Trial reportBMC anesthesiology2023
Effect of surgical pleth index-guided remifentanil administration on perioperative outcomes in elderly patients: a prospective randomized controlled trial.
Trial report in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06609993 (Thoracic Epidural Analgesia Using Bupivacaine or Ropivacaine With Fentanyl in Patients Undergoing Abdominal Aorctic Repair Under Adequacy of Anaestesia Guidance), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Thoracic Epidural Analgesia Using Bupivacaine or Ropivacaine With Fentanyl in Patients Undergoing Abdominal Aorctic Repair Under Adequacy of Anaestesia Guidance
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of Postoperative Opioid Consumption, Pain and Complications Following Intraoperative Autonomic Nervous System-Based Nociception Monitoring.European journal of pain (London, England) · 2026Pooled it
- Opioid administration guided by Surgical Pleth Index in patients with a combination of general and regional anaesthesia during trauma and orthopaedic surgery: a double-blind, randomised controlled trial.Journal of clinical monitoring and computing · 2026Trial
- EEG-Derived Pain Threshold Index-Guided Remifentanil Titration During Laparoscopic Abdominal Surgery: A Randomized Trial.Journal of pain research · 2026Trial
- The use of the surgical pleth index to guide anaesthesia in gastroenterological surgery: a randomised controlled study.Journal of clinical monitoring and computing · 2025Trial
- Progress in pain mechanisms and management.Signal transduction and targeted therapy · 2026Review
- Effect of IoC2-guided analgesic titration on intraoperative opioid consumption in older patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.Journal of anesthesia · 2026Article
- Surgical Pleth Index as a Potentially Useful and Noninvasive Tool for Assessing Tracheal Intubation Conditions in Female Patients During Neuromuscular Blockade-Free Anesthesia.Emergency medicine international · 2026Article
- Perioperative local anesthetics as modulators of tumor progression and metastasis.Frontiers in pharmacology · 2026Review
- Influence of Intraoperative Pain Management on Postoperative Delirium in Elderly Patients: A Prospective Single-Center Randomized Controlled Trial.Pain and therapy · 2025Article
- Adequacy of Anesthesia Guidance for Combined General/Epidural Anesthesia in Patients Undergoing Open Abdominal Infrarenal Aortic Aneurysm Repair; Preliminary Report on Hemodynamic Stability and Pain Perception.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOXIndian journal of anaesthesia · 2024Article
- Surgical pleth index monitoring in perioperative pain management: usefulness and limitations.Korean journal of anesthesiology · 2024Review
- The Impact of Nociception Monitor-Guided Multimodal General Anesthesia on Postoperative Outcomes in Patients Undergoing Laparoscopic Bowel Surgery: A Randomized Controlled Trial.Journal of clinical medicine · 2024Article
- Perioperative analgesia in the elderly.Saudi journal of anaesthesiaReview
- Implication of age-related changes on anesthesia management.Saudi journal of anaesthesiaReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundDuring general anesthesia, the surgical pleth index (SPI) monitors nociception. The evidence of SPI in the elderly remains scarce. We aimed to investigate whether there is a difference in perioperative outcomes following intraoperative opioid administration according to the surgical pleth index (SPI) value versus hemodynamic parameters (heart rate or blood pressure) in elderly patients.
methodsPatients aged 65-90 years who underwent laparoscopic colorectal cancer surgery under sevoflurane/remifentanil anesthesia were randomized to receive remifentanil guided by SPI (SPI group) or conventional clinical judgment based on hemodynamic parameters (conventional group). The primary endpoint was intraoperative remifentanil consumption. Secondary endpoints were intraoperative hemodynamic instability, pain score, fentanyl consumption and delirium in the post-anesthesia care unit (PACU), and perioperative changes in interleukin-6 and natural killer (NK) cell activity.
resultsSeventy-five patients (38, SPI; 37, conventional) were included in the study. The SPI group consumed significantly more remifentanil intraoperatively than the conventional group (mean ± SD, 0.13 ± 0.05 vs. 0.06 ± 0.04 μg/kg/min, P < 0.001). Intraoperative hypertension and tachycardia were more common in the conventional group than in the SPI group. Pain score in the PACU (P = 0.013) and the incidence of delirium in the PACU were significantly lower in the SPI group than the conventional group (5.2% vs. 24.3%, P = 0.02). There was no significant difference in NK cell activity and interleukin-6 level.
conclusionsIn the elderly patients, SPI-guided analgesia provided appropriate analgesia with sufficient intraoperative remifentanil consumption, lower incidence of hypertension/ tachycardia events, and a lower incidence of delirium in the PACU than the conventional analgesia. However, SPI-guided analgesia may not prevent perioperative immune system deterioration.
trial registrationThe randomized controlled trial was retrospectively registered in the UMIN Clinical Trials Registry (trial number: UMIN000048351; date of registration: 12/07/2022).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.