Adequacy of Anaesthesia for Colonoscopic Procedures

Surgical Pleth Index (SPI) is reported to properly reflect nociception-antinociception balance in patients undergoing surgical procedures, where a value of 100 corresponds to a high stress level and a value of 0 to a low stress level; values near 50 or increase in value > delta 10 correspond to the stress level which is known to reflect requirement for rescue analgesia.

The applicability of SPI- guided deep sedation regimen in colonoscopic procedures has not been previously studied. Additionally, depth of sedation markedly influences the nociception-antinociception balance so its monitoring also proved useful in procedures performed under deep sedation.

Therefore, we aim to investigate if both SPI-guided fentanyl administration alongside with State Entropy guided propofol aministration (Adequacy of Anaesthesia monitoring) versus State Entropy guided propofol aministration alongside with fentanyl titration based on haemodynamic parametres versus fentanyl titration based on haemodynamic parametres only influence both patients' or operator's satisfaction from anaesthetic management.

Inclusion criteria

• written consent to participate in the study
• written consent to undergo deep sedation for colonoscopic procedure
• general heath condition I-III of American Society of Anaesthesiology

Exclusion criteria

• necessity of administration of vasoactive drugs influencing SPI monitoring
• pregnancy
• anatomical malformation that make monitoring using SE sensor impossible
• general atherosclerosis, heart rhythm disturbances impairing SPI monitoring
• chronic medication using opioid drugs leading to resistancy to opioids.