Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial
Background and Aims: Adequacy of Anaesthesia (AoA) and CONOX® are combined monitors that assess levels of anaesthesia and analgesia and give a comprehensive score. No studies have measured and compared the total consumption of inhaled anaesthetic agents while using these monitors. We designed a stud...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_174_24 |
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| author | Rajendran. Arulkumaran Anusha Cherian Aswini Kuberan Prasanna Udupi Bidkar |
| author_facet | Rajendran. Arulkumaran Anusha Cherian Aswini Kuberan Prasanna Udupi Bidkar |
| author_sort | Rajendran. Arulkumaran |
| collection | DOAJ |
| description | Background and Aims:
Adequacy of Anaesthesia (AoA) and CONOX® are combined monitors that assess levels of anaesthesia and analgesia and give a comprehensive score. No studies have measured and compared the total consumption of inhaled anaesthetic agents while using these monitors. We designed a study to compare AoA and CONOX in terms of sevoflurane usage, fentanyl usage and recovery from the effects of anaesthesia.
Methods:
A randomised trial was conducted in 58 patients. Group A (n = 31) patients were monitored with AoA, and Group C (n = 27) patients were monitored with CONOX. Sevoflurane was titrated to maintain a state entropy value of 40–60 in AoA and a Quantium consciousness index (qCON) value of 40–60 in CONOX. Similarly, fentanyl was titrated with bolus doses of 0.5 μg/kg to maintain a surgical pleth index value of 40–60 in AoA and Quantium noxious index (qNOX) value of 40–60 in CONOX. Intraoperative awareness was assessed postoperatively using a modified Brice questionnaire. The t-test or Chi-square test was used to compare the parameters between the groups.
Results:
Mean sevoflurane consumption was similar between AoA and CONOX groups [13.2 (standard deviation {SD}: 3.9) (95% confidence interval {CI}:11.8, 14.5) versus 14.4 (SD: 3.7) (95% CI: 13.0, 15.7) ml/h] (P = 0.236). Fentanyl usage was higher in the AoA group compared to the CONOX group [146.2 (SD: 34.28) (95% CI: 134.13, 158.26) versus 128.2 (SD: 26.7) (95% CI: 118.12, 138.27) μg] (P = 0.031). The emergence time and haemodynamic instability events were similar between AoA and CONOX.
Conclusion:
Both AoA and CONOX measure anaesthetic depth similarly. However, interpreting qNOX values requires caution, as the patient’s consciousness status influences them. |
| format | Article |
| id | doaj-art-85c1628caf8d4e878a0c78edf795a935 |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-85c1628caf8d4e878a0c78edf795a9352025-01-24T15:13:21ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-11-016811996100210.4103/ija.ija_174_24Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trialRajendran. ArulkumaranAnusha CherianAswini KuberanPrasanna Udupi BidkarBackground and Aims: Adequacy of Anaesthesia (AoA) and CONOX® are combined monitors that assess levels of anaesthesia and analgesia and give a comprehensive score. No studies have measured and compared the total consumption of inhaled anaesthetic agents while using these monitors. We designed a study to compare AoA and CONOX in terms of sevoflurane usage, fentanyl usage and recovery from the effects of anaesthesia. Methods: A randomised trial was conducted in 58 patients. Group A (n = 31) patients were monitored with AoA, and Group C (n = 27) patients were monitored with CONOX. Sevoflurane was titrated to maintain a state entropy value of 40–60 in AoA and a Quantium consciousness index (qCON) value of 40–60 in CONOX. Similarly, fentanyl was titrated with bolus doses of 0.5 μg/kg to maintain a surgical pleth index value of 40–60 in AoA and Quantium noxious index (qNOX) value of 40–60 in CONOX. Intraoperative awareness was assessed postoperatively using a modified Brice questionnaire. The t-test or Chi-square test was used to compare the parameters between the groups. Results: Mean sevoflurane consumption was similar between AoA and CONOX groups [13.2 (standard deviation {SD}: 3.9) (95% confidence interval {CI}:11.8, 14.5) versus 14.4 (SD: 3.7) (95% CI: 13.0, 15.7) ml/h] (P = 0.236). Fentanyl usage was higher in the AoA group compared to the CONOX group [146.2 (SD: 34.28) (95% CI: 134.13, 158.26) versus 128.2 (SD: 26.7) (95% CI: 118.12, 138.27) μg] (P = 0.031). The emergence time and haemodynamic instability events were similar between AoA and CONOX. Conclusion: Both AoA and CONOX measure anaesthetic depth similarly. However, interpreting qNOX values requires caution, as the patient’s consciousness status influences them.https://journals.lww.com/10.4103/ija.ija_174_24adequacy of anaesthesiaanaestheticsfentanylgeneralinhalationqconqnoxquantium consciousness indexsevofluranesurgical pleth index |
| spellingShingle | Rajendran. Arulkumaran Anusha Cherian Aswini Kuberan Prasanna Udupi Bidkar Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial Indian Journal of Anaesthesia adequacy of anaesthesia anaesthetics fentanyl general inhalation qcon qnox quantium consciousness index sevoflurane surgical pleth index |
| title | Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial |
| title_full | Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial |
| title_fullStr | Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial |
| title_full_unstemmed | Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial |
| title_short | Comparison of Adequacy of Anaesthesia (AoA) monitors with CONOX® monitor regarding sevoflurane consumption during routine general anaesthesia: A randomised clinical trial |
| title_sort | comparison of adequacy of anaesthesia aoa monitors with conox r monitor regarding sevoflurane consumption during routine general anaesthesia a randomised clinical trial |
| topic | adequacy of anaesthesia anaesthetics fentanyl general inhalation qcon qnox quantium consciousness index sevoflurane surgical pleth index |
| url | https://journals.lww.com/10.4103/ija.ija_174_24 |
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