qCON/qNOX-Guided Anesthesia in Patients Undergoing Thyroidectomy Surgery

April 16, 2026 updated by: Çiğdem Ünal Kantekin, Kayseri City Hospital

The Effect of qCON/qNOX-Guided Anesthesia Using the Conox Monitor on Clinical Outcomes in Patients Undergoing Thyroidectomy Surgery

The aim of this study is to evaluate the effect of using the non-invasive Conox monitor on intraoperative opioid consumption. Additionally, the study aims to assess the impact of Conox monitoring on recovery time, postoperative agitation rate, and pain scores, and to investigate the correlation between qCON and qNOX values and conventional hemodynamic parameters.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

In recent years, both nationally and internationally, strategies aimed at minimizing perioperative opioid use and protocols designed to enhance postoperative recovery have gained increasing importance in anesthesia practice. The primary objectives of these developments are to improve patient care, minimize undesirable events, promote earlier discharge, and prevent long-term adverse outcomes .

Although opioids play an essential role in multimodal perioperative analgesia due to their proven efficacy, safety, and titratability, it is important to use the lowest effective opioid dose possible.

In thyroid surgery, neuromuscular blocking agents are not used after induction. Maintenance of anesthesia is achieved with inhalational anesthetic agents and opioids. Therefore, adequate titration of anesthetic depth directly affects postoperative comfort, drug consumption, and overall recovery .

The Conox monitor is a non-invasive, EEG-based monitoring device that simultaneously provides hypnosis (qCON) and analgesia/nociception (qNOX) indices. The current anesthesia depth monitoring devices used in our anesthesia unit allow monitoring of anesthetic depth only. However, nociception is one of the critical components of anesthesia. Nociception is defined as the patient's ability to respond to painful stimuli in relation to the effectiveness of administered analgesic agents. Proper management of painful stimuli during surgery enhances patient safety and allows optimal drug dosing.

By reducing unnecessary drug administration, postoperative complications may decrease and recovery can be positively influenced. The Conox monitoring system, based on EEG signals, offers the opportunity to monitor both anesthetic depth and nociception simultaneously . Combined monitoring of anesthetic depth and nociception provides anesthesiologists with a safer, more sensitive, and comprehensive monitoring approach, thereby improving the quality of patient care.

This study aims to investigate whether Conox monitoring provides clinical advantages compared with routine physiological parameter monitoring.

Study Type

Interventional

Enrollment (Estimated)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Çiğdem Ünal Kantekin, MD
  • Phone Number: +905054433056
  • Email: drcgdm@gmail.com

Study Locations

  • Turkey (Türkiye)
    • Kayseri
      • Kayseri, Kayseri, Turkey (Türkiye), 38080
        • Recruiting
        • Kayseri City Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Patients aged 18-70 years
  • Thyroidectomy cases with ASA physical status I-II
  • Patients who have provided written informed consent

Exclusion Criteria:

  • Skin lesions preventing EEG electrode placement
  • Neurological disorders (e.g., epilepsy)
  • Anticipated difficult airway

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Conox

Induction: Propofol 2-3 mg/kg, fentanyl 2 µg/kg, and rocuronium 0.6 mg/kg. Maintenance: Sevoflurane (1.0-1.3 MAC) and remifentanil infusion at 0.1 µg/kg/h.

In the Conox group, anesthetic and analgesic titration will be performed targeting qCON values of 40-60 and qNOX values of 30-60.
Device: Connox EEG Monitoring
Conox EEG monitor will be applied intraoperatively. Anesthetic and opioid titration will be guided by qCON values between 40-60 and qNOX values between 30-60. Opioid administration will be adjusted according to qNOX levels in addition to standard clinical monitoring.
Active Comparator: control

Induction: Propofol 2-3 mg/kg, fentanyl 2 µg/kg, and rocuronium 0.6 mg/kg. Maintenance: Sevoflurane (1.0-1.3 MAC) and remifentanil infusion at 0.1 µg/kg/h.In the control group, conventional titration will be guided by heart rate and mean arterial pressure changes.

Total intraoperative opioid consumption, recovery time, extubation time, agitation scores, and pain scores will be recorded.
Other: standard anesthesia management
Standard anesthesia management will be performed according to routine clinical practice. Opioid titration will be guided by conventional hemodynamic parameters including heart rate and mean arterial pressure. No EEG-based monitoring will be used for analgesia titration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total intraoperative opioid consumption
Time Frame: Intraoperative period
Total intraoperative opioid consumption will be defined as the cumulative dose of remifentanil (µg/kg) administered from induction of anesthesia until completion of surgery (skin closure). Data will be obtained from anesthesia records and analyzed comparatively between the study groups.
Intraoperative period

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Correlation between qCON/qNOX values and hemodynamic parameters
Time Frame: Intraoperative period
The correlation between qCON and qNOX indices and hemodynamic parameters (heart rate and mean arterial pressure) will be evaluated during the intraoperative period. Values will be recorded at predefined intervals and analyzed using correlation analysis.
Intraoperative period
Postoperative pain scores
Time Frame: Within the first 30 minutes after surgery in the PACU (assessed every 5 minutes)
Postoperative pain intensity will be assessed using the Visual Analog Scale(VAS), A 0 to 10 numerical rating scale, where 0 indicates no pain and 10 indicates the worst imaginable pain. Pain scores will be recorded every five minutes during the first 30 minutes in the post-anesthesia care unit (PACU).
Within the first 30 minutes after surgery in the PACU (assessed every 5 minutes)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kayseri City Hospital

Investigators

  • Principal Investigator: çiğdem ünal kantekin, MD, Kayseri City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 10, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

June 30, 2026

Study Registration Dates

First Submitted

February 25, 2026

First Submitted That Met QC Criteria

February 25, 2026

First Posted (Actual)

March 3, 2026

Study Record Updates

Last Update Posted (Actual)

April 20, 2026

Last Update Submitted That Met QC Criteria

April 16, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • KSH-SBU-CUK-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared due to institutional regulations and ethical considerations. The study will be conducted at a single center, and data sharing was not included in the informed consent process.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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