Preprint Review Version 2 Preserved in Portico This version is not peer-reviewed

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

Version 1 : Received: 24 November 2020 / Approved: 26 November 2020 / Online: 26 November 2020 (08:35:42 CET)
Version 2 : Received: 23 January 2021 / Approved: 25 January 2021 / Online: 25 January 2021 (17:02:57 CET)

A peer-reviewed article of this Preprint also exists.

Rogobete, A.F.; Bedreag, O.H.; Papurica, M.; Popovici, S.E.; Bratu, L.M.; Rata, A.; Barsac, C.R.; Maghiar, A.; Garofil, D.N.; Negrea, M.; Petcu, L.B.; Toma, D.; Dumbuleu, C.M.; Rimawi, S.; Sandesc, D. Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance during General Anesthesia—A New Era in Patient Safety Standards and Healthcare Management. Medicina 2021, 57, 132. Rogobete, A.F.; Bedreag, O.H.; Papurica, M.; Popovici, S.E.; Bratu, L.M.; Rata, A.; Barsac, C.R.; Maghiar, A.; Garofil, D.N.; Negrea, M.; Petcu, L.B.; Toma, D.; Dumbuleu, C.M.; Rimawi, S.; Sandesc, D. Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance during General Anesthesia—A New Era in Patient Safety Standards and Healthcare Management. Medicina 2021, 57, 132.

Journal reference: Medicina 2021, 57, 132
DOI: 10.3390/medicina57020132

Abstract

With the development of general anesthesia techniques and anesthetic substances, brought new horizons for the expansion and improvement of surgical techniques. Nevertheless, more complex surgical procedures brought a higher complexity and longer duration for general anesthesia that led to a series of adverse events such as hemodynamic instability, under- or overdosage of anesthetic drugs, as well as an increased number of post-anesthetic events. In order to adapt the anesthesia according to the particularities of each patient, the multimodal monitoring of these patients is highly recommended. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, and the reduction of post-operative complications. Another important aspect is the impact on the status of inflammation and the redox balance. By minimizing inflammatory and oxidative impact one can achieve a faster recovery that will lead to both increased patient satisfaction and an increase in patient safety. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

Keywords

hypnosis; multimodal monitoring; entropy; qNOX; qCON; bispectral index; surgical plethismographic index; general anaesthesia; patient safety

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