Journal of anesthesia, analgesia and critical care · 2025
Influence of qNOX-guided remifentanil titration on intraoperative dosing and postoperative pain in total knee arthroplasty: a pilot randomized trial.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Liu Fengrong, Wang E, Huang Bei, Yang Donglin, Gao Xiaowei
Аннотация
BACKGROUND: Accurate nociception monitoring may optimize opioid administration during total knee arthroplasty. We aimed to evaluate whether the quantium nociception index (qNOX)-guided remifentanil infusion reduces opioid consumption and improves postoperative analgesia.
METHODS: In this single-blind randomized trial, 84 patients undergoing total knee arthroplasty received either qNOX-guided (M group, n = 42) or conventional remifentanil infusion (R group, n = 42). Primary outcome was the incidence of Visual Analogue Scale (VAS) ≥ 5 within 40 min postoperatively. Secondary outcomes included intraoperative remifentanil/propofol consumption, Quality of Recovery (QoR)-15 questionnaire, postoperative nausea and vomiting, hospital stay, and hemodynamic stability.
RESULTS: M group demonstrated the following: Lower resting VAS ≥ 5 incidence (16.7% vs. 55.6%; relative risk [RR] 0.30, 95% CI 0.15 to 0.63; P = 0.023). The qNOX-guided strategy also led to a significant reduction in intraoperative remifentanil consumption (0.071 vs. 0.083 µg·kg⁻1·min⁻1; P = 0.001) and a faster time to extubation (median 16 vs. 18 min; P = 0.009). No differences were observed in propofol consumption, QoR-15 scores, or the incidence of postoperative nausea and vomiting.
CONCLUSION: qNOX-guided analgesia reduces intraoperative remifentanil requirements, accelerates recovery, and improves early postoperative pain control without increasing adverse events.
TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2500107430. Registered August 11th, 2025, retrospectively registered.
METHODS: In this single-blind randomized trial, 84 patients undergoing total knee arthroplasty received either qNOX-guided (M group, n = 42) or conventional remifentanil infusion (R group, n = 42). Primary outcome was the incidence of Visual Analogue Scale (VAS) ≥ 5 within 40 min postoperatively. Secondary outcomes included intraoperative remifentanil/propofol consumption, Quality of Recovery (QoR)-15 questionnaire, postoperative nausea and vomiting, hospital stay, and hemodynamic stability.
RESULTS: M group demonstrated the following: Lower resting VAS ≥ 5 incidence (16.7% vs. 55.6%; relative risk [RR] 0.30, 95% CI 0.15 to 0.63; P = 0.023). The qNOX-guided strategy also led to a significant reduction in intraoperative remifentanil consumption (0.071 vs. 0.083 µg·kg⁻1·min⁻1; P = 0.001) and a faster time to extubation (median 16 vs. 18 min; P = 0.009). No differences were observed in propofol consumption, QoR-15 scores, or the incidence of postoperative nausea and vomiting.
CONCLUSION: qNOX-guided analgesia reduces intraoperative remifentanil requirements, accelerates recovery, and improves early postoperative pain control without increasing adverse events.
TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2500107430. Registered August 11th, 2025, retrospectively registered.