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Altoufaili M.H.

National Medical Research Center for Otorhinolaryngology

Klypa T.V.

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Ryazanov V.B.

National Medical Research Center for Otorhinolaryngology

Mandel I.A.

Federal Scientific Clinical Center for Specialized Medical Care and Medical Technologies;
Sechenov First Moscow State Medical University (Sechenov University)

Intraoperative monitoring of sedation and analgesia in patients over 70 years old in ENT surgery: a randomized prospective study

Authors:

Altoufaili M.H., Klypa T.V., Ryazanov V.B., Mandel I.A.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(4): 24‑31

DOI: 10.17116/anaesthesiology202404124

Read: 1166 times

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Table of contents

INTRAOPERATIVE MONITORING OF SEDATION AND ANALGESIA IN PATIENTS OVER 70 YEARS OLD IN ENT SURGERY: A RANDOMIZED PROSPECTIVE STUDY
INTRAOPERATIVE MONITORING OF SEDATION AND ANALGESIA IN PATIENTS OVER 70 YEARS OLD IN ENT SURGERY: A RANDOMIZED PROSPECTIVE STUDY

To cite this article:

Altoufaili MH, Klypa TV, Ryazanov VB, Mandel IA. Intraoperative monitoring of sedation and analgesia in patients over 70 years old in ENT surgery: a randomized prospective study. Russian Journal of Anesthesiology and Reanimatology. 2024;(4):24‑31. (In Russ.)
https://doi.org/10.17116/anaesthesiology202404124

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Abstract:

OBJECTIVE

To analyze the effectiveness of EEG-based monitoring of anesthesia (qCON) and analgesia (qNOX) in older patients undergoing ENT surgery.

MATERIAL AND METHODS

A randomized prospective study included 66 patients (70—85 years old, ASA III-IV) who underwent ENT surgery. All ones were divided into 2 equal groups: group A — general anesthesia under CONOX monitoring, group B — standard monitoring. We estimated doses of propofol, fentanyl and sevoflurane, intraoperative hemodynamic profile, intraoperative awakening, postoperative nausea and vomiting (PONV), need for additional analgesia in early postoperative period.

RESULTS

The total amount of propofol for induction of anesthesia was lower in group A (1.6 [1.30—1.77] vs. 1.76 [1.54—1.90] mg/kg (p=0.016). Dose of fentanyl amounted to 1.92 [1.62—3.13] and 2.21 [1.35—3.71] µg/kg/hour, respectively (p=0.672). Dose of sevoflurane was similar in both groups. Intraoperative hemodynamic disorders requiring vasopressor and/or hypotonic drugs occurred in 3 (9%) and 6 (18%) patients, respectively. PONV developed in 3 (9%) and 6 (18%) patients, respectively. Intraoperative awakening was observed in 1 (3%) and 3 (9%) patients, respectively. In early postoperative period, 13 (39%) patients in each group complained of pain and needed for additional analgesia without between-group differences in these indicators.

CONCLUSION

EEG-based monitoring of anesthesia and analgesia in people over 70 years old undergoing ENT surgery is valuable to optimize doses of analgesics and hypnotics, reduce the incidence and severity of hemodynamic disturbances, intraoperative awakening and PONV.

Keywords:

anesthesia
intraoperative monitoring
ENT
geriatrics

Authors:

Altoufaili M.H.

National Medical Research Center for Otorhinolaryngology

Klypa T.V.

Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies

Ryazanov V.B.

National Medical Research Center for Otorhinolaryngology

Mandel I.A.

Federal Scientific Clinical Center for Specialized Medical Care and Medical Technologies;
Sechenov First Moscow State Medical University (Sechenov University)

Received:

02.10.2023

Accepted:

28.02.2024

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