ArticleJournal of anesthesia, analgesia and critical care2025
Influence of qNOX-guided remifentanil titration on intraoperative dosing and postoperative pain in total knee arthroplasty: a pilot randomized trial.
Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundAccurate nociception monitoring may optimize opioid administration during total knee arthroplasty. We aimed to evaluate whether the quantium nociception index (qNOX)-guided remifentanil infusion reduces opioid consumption and improves postoperative analgesia.
methodsIn this single-blind randomized trial, 84 patients undergoing total knee arthroplasty received either qNOX-guided (M group, n = 42) or conventional remifentanil infusion (R group, n = 42). Primary outcome was the incidence of Visual Analogue Scale (VAS) ≥ 5 within 40 min postoperatively. Secondary outcomes included intraoperative remifentanil/propofol consumption, Quality of Recovery (QoR)-15 questionnaire, postoperative nausea and vomiting, hospital stay, and hemodynamic stability.
resultsM group demonstrated the following: Lower resting VAS ≥ 5 incidence (16.7% vs. 55.6%; relative risk [RR] 0.30, 95% CI 0.15 to 0.63; P = 0.023). The qNOX-guided strategy also led to a significant reduction in intraoperative remifentanil consumption (0.071 vs. 0.083 µg·kg⁻
conclusionqNOX-guided analgesia reduces intraoperative remifentanil requirements, accelerates recovery, and improves early postoperative pain control without increasing adverse events.
trial registrationChinese Clinical Trial Registry, ChiCTR2500107430. Registered August 11th, 2025, retrospectively registered.
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