Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5221
Peer-review started: June 13, 2020
First decision: July 25, 2020
Revised: August 5, 2020
Accepted: September 28, 2020
Article in press: September 28, 2020
Published online: November 6, 2020
The wavelet index (WLi) and pain rating index (PRi) are new parameters developed by Chinese researchers that could be used to regulate depth of general anesthesia based on wavelet analysis.
The WLi and the PRi are currently understudied, although they could be more effective in regulating the depth of general anesthesia compared with standard monitoring of systolic blood pressure (SBP).
To investigate the safety and efficacy of using WLi and PRi in sevoflurane-based general anesthesia.
Patients scheduled for elective posterior lumbar interbody fusion surgery under sevoflurane anesthesia were assigned to the SBP, WLi, and PRi monitoring groups. The primary endpoint was anesthesia recovery time. Secondary endpoints included extubation time, sevoflurane consumption, number of unwanted events/interventions, number of adverse events, and postoperative visual analogue scale for pain.
The SBP, WLi, and PRi groups included 21, 21, and 20 patients, respectively. Anesthesia recovery time was shorter in the WLi and PRi groups than in the SBP group with no significant difference between the WLi and PRi groups. Extubation time was shorter in the WLi and PRi groups than in the SBP group. Sevoflurane consumption was lower in the WLi and PRi groups than in the SBP group. Nicardipine was more commonly needed to treat hypertension in the WLi and PRi groups than in the SBP group.
Regulating sevoflurane anesthesia depth with WLi or PRi reduced anesthesia recovery time, extubation time, and sevoflurane consumption without intraoperative unwanted events.
Large multicenter studies are needed to improve the generalizability of the current findings. Additional research is warranted to explore the utility of WLi and PRi in patients undergoing other surgical procedures or other administered general anesthetics. Further studies should be performed to reduce the susceptibility of WLi and PRi values to interference from the electrotome and postural changes. Such studies might promote the widespread use of these tools in the future.