Zhang JW, Lv ZG, Kong Y, Han CF, Wang BG. Wavelet and pain rating index for inhalation anesthesia: A randomized controlled trial. World J Clin Cases 2020; 8(21): 5221-5234 [PMID: 33269258 DOI: 10.12998/wjcc.v8.i21.5221]
Corresponding Author of This Article
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
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
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 byKey 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
ARTICLE HIGHLIGHTS
Research background
The wavelet index (WLi) and pain rating index (PRi) are new parameters developed by Chinese researchers that could be used to regulate depth of general anesthesia based on wavelet analysis.
Research motivation
The WLi and the PRi are currently understudied, although they could be more effective in regulating the depth of general anesthesia compared with standard monitoring of systolic blood pressure (SBP).
Research objectives
To investigate the safety and efficacy of using WLi and PRi in sevoflurane-based general anesthesia.
Research methods
Patients scheduled for elective posterior lumbar interbody fusion surgery under sevoflurane anesthesia were assigned to the SBP, WLi, and PRi monitoring groups. 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.
Research results
The SBP, WLi, and PRi groups included 21, 21, and 20 patients, respectively. 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.
Research conclusions
Regulating sevoflurane anesthesia depth with WLi or PRi reduced anesthesia recovery time, extubation time, and sevoflurane consumption without intraoperative unwanted events.
Research perspectives
Large multicenter studies are needed to improve the generalizability of the current findings. Additional research is warranted to explore the utility of WLi and PRi in patients undergoing other surgical procedures or other administered general anesthetics. Further studies should be performed to reduce the susceptibility of WLi and PRi values to interference from the electrotome and postural changes. Such studies might promote the widespread use of these tools in the future.
