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

Alexandru Florin Rogobete; Ovidiu Horea Bedreag; Marius Papurica; Sonia Elena Popovici; Lavinia Melania Bratu; Andreea Rata; Claudiu Rafael Barsac; Andra Maghiar; Dragos Nicolae Garofil; Mihai Negrea; Laura Bostangiu Petcu; Daiana Toma; Corina Maria Dumbuleu; Samir Rimawi; Dorel Sandesc

doi:10.20944/preprints202011.0657.v2

Preprint Review Version 2 Preserved in Portico This version is not peer-reviewed

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)

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.

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

Medicine and Pharmacology, Immunology and Allergy

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

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