Comparison of Adequacy of Anesthesia Monitoring With Standard Clinical Practice During Routine General Anesthesia

Study Overview
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Brief Summary
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The purpose of this study is to demonstrate that using Surgical Pleth Index (SPI) and Entropy in adjunct to other clinical information decreases the occurrence rate of inadequate anesthesia events, bradycardia and hypotension in comparison to standard clinical practice during anesthesia. Adequacy of Anesthesia (AoA) monitoring comprises the use of both Entropy and SPI measurements. Adequacy of anesthesia will be monitored using non-invasive blood pressure, blood oxygen saturation (SpO2), ECG, and neuromuscular transmission (NMT).

Official Title
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Comparison of Adequacy of Anesthesia Monitoring With Standard Clinical Practice During Routine General Anesthesia

Conditions
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Surgical Procedure, Unspecified

Intervention / Treatment
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* Device: AoA Monitoring
* Device: Routine (Standard) Anesthesia Monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to provide written informed consent Age 18-80 years of age Surgery that is expected to last at least 2 hours under general anesthesia with endotracheal tube Exclusion Criteria: Any subject that meets the definition of vulnerable subject as defined in ISO 14155:2011 Per ISO 14155:2011, a vulnerable subject is defined as an individual whose willingness to volunteer in a clinical investigation could be unduly influenced by the expectation, whether justified or not, of benefits associated with participation or of retaliatory response from senior members of a hierarchy in case of refusal to participate Any subject with a cardiac pacemaker Any subject with atrial fibrillation at the time of obtaining the baseline values Any subject with more than 5 ventricular extra systoles/minute at the time of obtaining the baseline values Any subject who needs invasive blood pressure measurement Any subject who show hemodynamics that would have qualified for being considered as a sign of inadequate anesthesia already at baseline: Mean blood pressure below 60 mmHg or above 100 mmHg HR below 45 /min or above 100/min Any subject with epidural anesthesia or analgesia during the surgery. Epidural catheter may be placed pre-operatively, and used in the PACU, but not during the surgery Any subject having surgery that requires prone position Any subject with very high body mass index (>35) because of incompatibility with the target controlled anesthesia models used Any subject with known allergies to the specific anesthetic agents/ analgesic drugs intended for use in their surgeries Any subject with laryngeal mask airway Any subject who requires neuromuscular blocking agent infusion Any subject who is going to have major surgery with a high risk of extensive blood loss Any subject with known chronic use of opioids

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Adequacy of Anesthesia (AoA) Monitoring<br>Adequacy of Anesthesia monitoring with SPI and Entropy | Device: AoA Monitoring<br>* Monitoring with Entropy and SPI parameters during surgery<br>|
| Active Comparator: Routine (Standard) Anesthesia Monitoring<br> | Device: Routine (Standard) Anesthesia Monitoring<br>* Standard of care monitoring<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of hemodynamic instability | Incidence of hemodynamic instability including hypertension, hypotension, tachycardia, and bradycardia | Participants will be followed for the duration of their surgery |