PMID- 24322572
OWN - NLM
STAT- MEDLINE
DCOM- 20140508
LR  - 20220317
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 112
IP  - 4
DP  - 2014 Apr
TI  - Randomized controlled trial of the effect of depth of anaesthesia on 
      postoperative pain.
PG  - 675-80
LID - 10.1093/bja/aet419 [doi]
AB  - 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.
FAU - Law, C J
AU  - Law CJ
AD  - Department of Anaesthesia, Anglesea Hospital, Knox Street Clinic, PO Box 228, 
      Hamilton Waikato 3204, New Zealand.
FAU - Jacobson, G M
AU  - Jacobson GM
FAU - Kluger, M
AU  - Kluger M
FAU - Chaddock, M
AU  - Chaddock M
FAU - Scott, M
AU  - Scott M
FAU - Sleigh, J W
AU  - Sleigh JW
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20131208
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anesthetics, Inhalation)
RN  - 76I7G6D29C (Morphine)
RN  - CRS35BZ94Q (Desflurane)
RN  - CYS9AKD70P (Isoflurane)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Analgesia, Patient-Controlled/methods
MH  - Analgesics, Opioid/administration & dosage/blood
MH  - Anesthesia, General/*methods
MH  - Anesthetics, Inhalation/administration & dosage
MH  - Desflurane
MH  - Double-Blind Method
MH  - Drug Administration Schedule
MH  - Electroencephalography/methods
MH  - Female
MH  - Fentanyl/administration & dosage/blood
MH  - Humans
MH  - Isoflurane/administration & dosage/analogs & derivatives
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/methods
MH  - Morphine/administration & dosage
MH  - Pain Measurement/methods
MH  - Pain, Postoperative/*prevention & control
MH  - Young Adult
OTO - NOTNLM
OT  - depth of anaesthesia
OT  - postoperative pain
EDAT- 2013/12/11 06:00
MHDA- 2014/05/09 06:00
CRDT- 2013/12/11 06:00
PHST- 2013/12/11 06:00 [entrez]
PHST- 2013/12/11 06:00 [pubmed]
PHST- 2014/05/09 06:00 [medline]
AID - S0007-0912(17)30883-8 [pii]
AID - 10.1093/bja/aet419 [doi]
PST - ppublish
SO  - Br J Anaesth. 2014 Apr;112(4):675-80. doi: 10.1093/bja/aet419. Epub 2013 Dec 8.