Influence of Nociception Level Monitor (NOL)-Guided Analgesic Delivery on Perioperative Course in Breast Surgeries: A Randomized Controlled Trial
2024

Nociception Level Monitor and Pain Management in Breast Surgery

Sample size: 58 publication 10 minutes Evidence: moderate

Author Information

Author(s): Malachauskiene Laima, Bhavsar Rajesh, Bakke Skule, Keller Jeppe, Bhavsar Swati, Luy Anne-Marie, Strøm Thomas

Primary Institution: Department of Anesthesia and Critical Care Medicine, South Jutland Hospitals, South Denmark University

Hypothesis

Does NOL-guided analgesic delivery reduce opioid consumption and improve perioperative outcomes in breast surgeries?

Conclusion

Using a NOL monitor reduces the amount of opioids needed during breast surgeries without affecting recovery outcomes.

Supporting Evidence

  • The study group used significantly less remifentanil (0.9 mg) compared to the control group (1.35 mg).
  • The study group also required less morphine (2.5 mg) than the control group (5 mg).
  • There was no significant difference in postoperative nausea and vomiting between the groups.
  • Both groups had similar eligibility times for discharge from the recovery room.

Takeaway

Doctors used a special monitor to help give less pain medicine during breast surgery, which worked well without causing other problems.

Methodology

This was a randomized controlled trial with 60 female patients undergoing breast cancer surgery, comparing NOL-guided analgesia to standard care.

Limitations

The study may be underpowered to detect differences in postoperative nausea and vomiting due to the small sample size.

Participant Demographics

Female patients aged 18 to 80 years with ASA classification I–IV scheduled for elective mastectomy.

Statistical Information

P-Value

{"remifentanil":0.033,"morphine":0.013,"TCI_remifentanil":0.001}

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/medicina60121921

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