Randomized Controlled Trial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5221-5234
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5221
Wavelet and pain rating index for inhalation anesthesia: A randomized controlled trial
Jian-Wen Zhang, Zhi-Gan Lv, Ying Kong, Chong-Fang Han, Bao-Guo Wang
Jian-Wen Zhang, Bao-Guo Wang, Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
Jian-Wen Zhang, Zhi-Gan Lv, Ying Kong, Chong-Fang Han, Department of Anesthesiology, Shanxi Dayi Hospital, Taiyuan 030032, Shanxi Province, China
Author contributions: Zhang JW designed the study, analyzed the data and drafted the manuscript; Lv ZG and Kong Y implemented the study protocol; Han CF designed and managed the study; Wang BG designed the study and analyzed the data; All authors reviewed the results and approved the final version of the manuscript.
Supported by Key Research and Development (R&D) Projects of Shanxi Province, China, No. 201803D31135.
Institutional review board statement: The study was approved by the Shanxi Dayi Hospital Ethical Committee (Approval No. YXLL-2017-005).
Clinical trial registration statement: This study was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR-IPR-17012092; date of registration: July 23, 2017).
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: The authors have no financial conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Guo Wang, MD, Doctor, Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, No. 50 Xiang Shan Yikesong, Haidian District, Beijing 100093, China. wbgttyy@163.com
Received: June 13, 2020
Peer-review started: June 13, 2020
First decision: July 25, 2020
Revised: August 5, 2020
Accepted: September 28, 2020
Article in press: September 28, 2020
Published online: November 6, 2020
Processing time: 146 Days and 0.7 Hours
Abstract
BACKGROUND

Wavelet index (WLi) and pain rating index (PRi) are new parameters for regulating general anesthesia depth based on wavelet analysis.

AIM

To investigate the safety and efficacy of using WLi or PRi in sevoflurane anesthesia.

METHODS

This randomized controlled trial enrolled 66 patients scheduled for elective posterior lumbar interbody fusion surgery under sevoflurane anesthesia between September 2017 and February 2018. A random number generator was used to assign the eligible patients to three groups: Systolic blood pressure (SBP) monitoring group, WLi monitoring group, and PRi monitoring group. The main anesthesiologist was aware of the patient grouping and intervention used. The primary endpoint was anesthesia recovery time. Secondary endpoints included extubation time, sevoflurane consumption, number of unwanted events/ interventions, number of adverse events and postoperative visual analogue scale for pain.

RESULTS

A total of 62 patients were included in the final analysis (SBP group, n = 21; WLi group, n = 21; and PRi group, n = 20). There were no significant differences among the three groups in patient age, gender distribution, body mass index, American Society of Anesthesiologists class, duration of surgery, or duration of anesthesia. Anesthesia recovery time was shorter in the WLi and PRi groups than in the SBP group with no significant difference between the WLi and PRi groups. Extubation time was shorter in the WLi and PRi groups than in the SBP group. Sevoflurane consumption was lower in the WLi and PRi groups than in the SBP group. Nicardipine was more commonly needed to treat hypertension in the WLi and PRi groups than in the SBP group.

CONCLUSION

Regulation of sevoflurane anesthesia depth with WLi or PRi reduced anesthesia recovery time, extubation time and sevoflurane consumption without intraoperative unwanted events.

Keywords: Wavelet index; Pain rating index; Sevoflurane; Depth of anesthesia; Anesthesiology; Systolic blood pressure

Core Tip: Anesthesia recovery time was shorter in the wavelet index (WLi) and pain rating index (PRi) groups than in the systolic blood pressure (SBP) group with no significant difference between the WLi and PRi groups. Extubation time was shorter in the WLi and PRi groups than in the SBP group. Sevoflurane consumption was lower in the WLi and PRi groups than in the SBP group. Nicardipine was more commonly needed to treat hypertension in the WLi and PRi groups than in the SBP group.