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SmartPilot® view-guided anaesthesia improves postoperative outcomes in hip fracture surgery: a randomized blinded controlled study.
Leblanc, D; Conté, M; Masson, G; Richard, F; Jeanneteau, A; Bouhours, G; Chrétien, J M; Rony, L; Rineau, E; Lasocki, S.
Afiliação
  • Leblanc D; Département Anesthésie Réanimation.
  • Conté M; Département Anesthésie Réanimation.
  • Masson G; Département Anesthésie Réanimation.
  • Richard F; Département Anesthésie Réanimation.
  • Jeanneteau A; Département Anesthésie Réanimation.
  • Bouhours G; Département Anesthésie Réanimation.
  • Chrétien JM; Maison de la recherche.
  • Rony L; Département de chirurgie osseuse, CHU Angers, 4 rue Larrey, F-49933 Angers Cedex 9, France.
  • Rineau E; Département Anesthésie Réanimation.
  • Lasocki S; Département Anesthésie Réanimation.
Br J Anaesth ; 119(5): 1022-1029, 2017 Nov 01.
Article em En | MEDLINE | ID: mdl-29028921
BACKGROUND: Both under-dosage and over-dosage of general anaesthetics can harm frail patients. We hypothesised that computer-assisted anaesthesia using pharmacokinetic/pharmacodynamic models guided by SmartPilot® View (SPV) software could optimise depth of anaesthesia and improve outcomes in patients undergoing hip fracture surgery. METHODS: This prospective, randomized, single-centre, blinded trial included patients undergoing hip fracture surgery under general anaesthesia. In the intervention group, anaesthesia was guided using SPV with predefined targets. In the control group, anaesthesia was delivered by usual practice using the same agents (propofol, sufentanil and desflurane). The primary endpoint was the time spent in the "appropriate anaesthesia zone" defined as bispectral index (BIS) (blinded to the anaesthetist during surgery) of 45-60 and systolic arterial pressure of 80-140 mm Hg. Postoperative complications were recorded for one month in a blinded manner. RESULTS: Of 100 subjects randomised, 97 were analysed (n=47 in SPV and 50 in control group). Anaesthetic drug consumption was reduced in the SPV group (for propofol and desflurane). Intraoperative duration of low BIS (<45) was similar, but cumulative time of low systolic arterial pressure (<80 mm Hg) was significantly shorter in the SPV group (median (Q1-Q3); 3 (0-40) vs 5 (0-116) min, P=0.013). SPV subjects experienced fewer moderate or major postoperative complications at 30-days (8 (17)% vs 18 (36)%, P=0.035) and shorter length of hospitalisation (8 (2-20) vs 8 (2-60) days, P=0.017). CONCLUSIONS: SmartPilot® View-guided anaesthesia reduces intraoperative hypotension duration, occurrence of postoperative complications and length of stay in hip fracture surgery patients. CLINICAL TRIAL REGISTRATION: NCT 02556658.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Quimioterapia Assistida por Computador / Fraturas do Quadril / Complicações Intraoperatórias / Anestesia Geral / Anestesiologia Tipo de estudo: Clinical_trials / Observational_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Quimioterapia Assistida por Computador / Fraturas do Quadril / Complicações Intraoperatórias / Anestesia Geral / Anestesiologia Tipo de estudo: Clinical_trials / Observational_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2017 Tipo de documento: Article