Comparison of Surgical Pleth Index–guided Analgesia with Conventional Analgesia Practices in Children

Park, Ji Hye; Lim, Byung Gun; Kim, Heezoo; Kong, Myoung Hoon; Kim, Nan Suk

doi:10.1097/aln.0000000000000650

Cited by 54 publications

(62 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[5,7,11,12] Some of these studies reported that the target range of SPI between 20 and 50 had been suboptimal for the analgesic titration. [13,14] …”

Section: Discussionmentioning

confidence: 99%

Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background:The surgical pleth index (SPI) is proposed for titration of analgesic drugs during general anesthesia. Several reports have investigated the effect of SPI on the consumption of opioids including remifentanil, fentanyl, and sufentanil during anesthesia, but there are no reports about oxycodone. We aimed to investigate intravenous oxycodone consumption between SPI-guided analgesia and conventional analgesia practices during sevoflurane anesthesia in patients undergoing thyroidectomy.Methods:Forty-five patients undergoing elective thyroidectomy were randomly assigned to an SPI group (SPI-guided analgesia group, n = 23) or a control group (conventional analgesia group, n = 22). Anesthesia was maintained with sevoflurane to achieve bispectral index values between 40 and 60. In the SPI group, oxycodone 1 mg was administered intravenously at SPI values over 50; in the control group, oxycodone 1 mg was administered intravenously at the occurrence of tachycardia or hypertension event. Intraoperative oxycodone consumption and extubation time were recorded. The number of hemodynamic and somatic movement events was recorded, as were postoperative pain and recovery scores.Results:Patients’ characteristics were comparable between the groups. Intraoperative oxycodone consumption in the SPI group was significantly lower than the control group (3.5 ± 2.4 vs 5.1 ± 2.4 mg; P = 0.012). Extubation time was significantly shorter in the SPI group (10.6 ± 3.5 vs 13.4 ± 4.6 min; P = 0.026). Hemodynamic and somatic movement events during anesthesia were comparable between the groups, as were numeric rating scales for pain and modified Aldrete scores at postanesthesia care unit.Conclusions:SPI-guided analgesia reduces intravenous oxycodone consumption and extubation time compared with conventional analgesia based on clinical parameters during sevoflurane anesthesia in patients undergoing thyroidectomy.

show abstract

“…[5,7,11,12] Some of these studies reported that the target range of SPI between 20 and 50 had been suboptimal for the analgesic titration. [13,14] …”

Section: Discussionmentioning

confidence: 99%

Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…9 However, the paediatric data are inconsistent and controversial. 8 The SPI has not been studied in children younger than 24 months of age. To our knowledge, this is the first study conducted in children aged <2 yr.…”

Section: Discussionmentioning

confidence: 99%

Surgical pleth index in children younger than 24 months of age: a randomized double-blinded trial

Harju

Kalliomäki

Leppikangas

et al. 2016

British Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Heart rate data was obtained by pulse oximetry measurements in both locations (DSU and BMTU). Tachycardia were defined as a 20 % increase above the mean heart rate [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

“Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients: a retrospective study”

et al. 2016

View full text Add to dashboard Cite

BackgroundLiver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children.MethodsThe study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6 %) biopsies were performed in the DSU and 56 (82.3 %) in the BMTU; nine (13.2 %) prior to HSCT and 59 (86.7 %) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: “calm and cooperative”, “agitated and non-cooperative” or “frightened and suffering”. Objective score was obtained measuring patient’s heart rate before the procedure and comparing it with mean heart rate.ResultsPatients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3 % of patients treated at the DSU were agitated as compared with 16.1 % of those treated at the BMTU (p < 0.01). Among the 59 biopsies performed after HSCT, 41 (69.5 %) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5 %) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9 %) cases. Minor complications occurred in about 17 % of procedures (12 biopsies), at a rate of 25 % for the DSU location compared with 16 % for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU.ConclusionLiver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.

show abstract

Comparison of Surgical Pleth Index–guided Analgesia with Conventional Analgesia Practices in Children

Abstract: As currently constructed, SPI does not appear to be valid in children. This may be due to both differences in blood vessel distensibility and baseline increased heart rates in children versus adults.

Cited by 54 publications

References 35 publications

Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

Comparison of relative oxycodone consumption in surgical pleth index-guided analgesia versus conventional analgesia during sevoflurane anesthesia

Surgical pleth index in children younger than 24 months of age: a randomized double-blinded trial

“Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients: a retrospective study”

Contact Info

Product

Resources

About