Reference : Comparison of the Surgical Pleth Index (TM) with haemodynamic variables to assess nocice...
Scientific journals : Article
Human health sciences : Neurology
Human health sciences : Anesthesia & intensive care
http://hdl.handle.net/2268/81473
Comparison of the Surgical Pleth Index (TM) with haemodynamic variables to assess nociception-anti-nociception balance during general anaesthesia
English
Bonhomme, Vincent mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Uutela, K. [> > > >]
Hans, Grégory mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Maquoi, Isabelle [Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs >]
Born, J. D. [> > > >]
Brichant, Jean-François mailto [Université de Liège - ULg > Département des sciences cliniques > Anesthésie et réanimation >]
Lamy, Maurice mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Hans, Pol [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
2011
British Journal of Anaesthesia
Oxford University Press
106
1
101-11
Yes (verified by ORBi)
International
0007-0912
1471-6771
Oxford
United Kingdom
[en] Anaesthetic techniques, i.v. ; monitoring, depth of anaesthesia ; pain, acute
[en] BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean arterial pressure (MAP), and heart rate (HR) as a means of assessing this balance. METHODS: We studied a standard stimulus [head-holder insertion (HHI)] and varying remifentanil concentrations (CeREMI) in a group of patients undergoing neurosurgery. Patients receiving target-controlled infusions were randomly assigned to one of the three CeREMI (2, 4, or 6 ng m(1)), whereas propofol target was fixed at 3 microg ml(1). Steady state for both targets was achieved before HHI. Intravascular volume status (IVS) was evaluated using respiratory variations in arterial pressure. Prediction probability (Pk) and ordinal regression were used to assess SPI, MAP, and HR performance at indicating CeREMI, and the influence of IVS and chronic treatment for high arterial pressure, as possible confounding factors. RESULTS: The maximum SPI, MAP, or HR observed after HHI correctly indicated CeREMI in one of the two patients [accurate prediction rate (APR)=0.5]. When IVS and chronic treatment for high arterial pressure were taken into account, the APR was 0.6 for each individual variable and 0.8 when all of them predicted the same CeREMI. That increase in APR paralleled an increase in Pk from 0.63 to 0.89. CONCLUSIONS: SPI, HR, and MAP are of comparable value at gauging noxious stimulation-CeREMI balance. Their interpretation is improved by taking account of IVS, treatment for chronic high arterial pressure, and concordance between their predictions.
http://hdl.handle.net/2268/81473
10.1093/bja/aeq291

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