Prediction of postoperative pain and analgesic requirements using surgical pleth index: a observational study

Park, MiHye; Kim, Byung Jun; Kim, Gaab Soo

doi:10.1007/s10877-019-00338-4

Cited by 8 publications

(23 citation statements)

References 19 publications

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“…Among the remaining 26 studies retrieved for full-text review, 20 were removed for failing to meet the inclusion criteria ( Supplementary Table S3 ). Finally, six observational studies involving adult surgical patients were included for the current meta-analysis [ 21 , 23 , 24 , 25 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…A total of 756 participants undergoing surgeries were recruited with an age range of 43–68 years. All studies excluded participants who used medications with potential interactions with the sympathovagal balance [ 21 , 23 , 24 , 25 , 30 , 31 ]. Frequency of the female gender ranged between 22.4% and 100%.…”

Section: Resultsmentioning

confidence: 99%

“…In the postoperative setting, SPI before arousal at the end of surgery has been shown to be higher in patients with postoperative moderate-to-severe pain than in those with no or mild pain in the postanesthesia care unit (PACU) [ 21 , 22 ], highlighting the significance of SPI in predicting postoperative pain immediately after surgery. Nevertheless, the efficacy of SPI for postoperative pain prediction based on the receiver operating characteristic (ROC) curve varied among studies [ 23 , 24 , 25 ]. The current meta-analysis aims to evaluate the diagnostic efficacy of SPI at the end of surgery in the prediction of postoperative moderate-to-severe pain.…”

Section: Introductionmentioning

confidence: 99%

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Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis

et al. 2022

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Despite acceptance of the surgical pleth index (SPI) for monitoring the intraoperative balance between noxious stimulation and anti-nociception under general anesthesia, its efficacy for predicting postoperative moderate-to-severe pain remains unclear. We searched electronic databases (e.g., Google Scholar, MEDLINE, Cochrane Library, and EMBASE) to identify articles focusing on associations of SPI at the end of surgery with immediate moderate-to-severe pain in the postanesthesia care unit from inception to 7 July 2022. A total of six observational studies involving 756 adults published between 2016 and 2020 were eligible for quantitative syntheses. Pooled results revealed higher values of SPI in patients with moderate-to-severe pain than those without (mean difference: 7.82, 95% CI: 3.69 to 11.95, p = 0.002, I2 = 46%). In addition, an elevated SPI at the end of surgery was able to predict moderate-to-severe pain with a sensitivity of 0.71 (95% confidence interval (CI): 0.65–0.77; I2 = 29.01%) and a specificity of 0.58 (95% CI: 0.39–0.74; I2 = 79.31%). The overall accuracy based on the summary receiver operating characteristic (sROC) curve was 0.72. In conclusion, this meta-analysis highlighted the feasibility of the surgical pleth index to predict postoperative moderate-to-severe pain immediately after surgery. Our results from a limited number of studies warrant further investigations for verification.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis

et al. 2022

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“…5,10 Also, we found there was considerable interindividual variation in pain intensity and opioid consumption through patient-controlled analgesia (PCA) even with similar surgical procedures after liver resection. 11 These results highlight the need for individual evaluation of pain sensitivity and individually optimized pain management.…”

Section: Introductionmentioning

confidence: 98%

“…16,17 Also, SPI values at the end of surgery were closely related to the degree of postoperative pain. 11,18,19 Thus, we tried to evaluate the level of stress response measured with SPI (SPI > 50 group vs SPI ≤ 50 group) and the steep increasing of SPI at equal MAC levels of end-tidal 3% sevoflurane during surgical incision 13,20 and compare the relationship with postoperative pain score and opioid consumption. We hypothesized the stress response to surgical incision based on SPI enables evaluation of pain sensitivity and that it can be used to predict postoperative pain and opioid consumption.…”

Section: Introductionmentioning

confidence: 99%

<p>Prediction of Postoperative Pain and Opioid Consumption Using Intraoperative Surgical Pleth Index After Surgical Incision: An Observational Study</p>

Jung

Park

Kim

et al. 2020

JPR

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Background: We evaluated whether the surgical pleth index (SPI) following surgical incision was related to postoperative pain and opioid consumption. Methods: This prospective observational study was performed in 50 patients undergoing laparotomy under sevoflurane-based general anesthesia. We recorded the highest SPI during surgical incision. The postoperative pain with a numerical rating scale (NRS) and opioid consumption during postoperative 24 h were compared in patients who showed SPI over 50 (Group H) or 20-50 (Group L). The relationship between postoperative opioid consumption and SPI values (pre-incision, post-incision SPI value, change of SPI value, and post-incision SPI minus pre-incision SPI) was evaluated using receiver-operating characteristic analysis. Results: The mean of the highest SPI value during surgical incision was 56 (SD, 12; range, 26-85). Twenty-nine (63%) patients were included in Group H and 17 (37%) patients in Group L. There was a significant difference in NRS during recovery room stay and on postoperative 24 h in two groups (5 [5, 6] vs 7 [6, 8], p=0.007 and 3.5 [3, 5] vs 5 [5,6], p=0.006, Group L vs Group H). Group H used higher fentanyl via patient control analgesia during postoperative 24 h (573 (253) µg vs 817 (305) µg, p=0.008). A change of pre-incision and post-incision SPI value of 23, which showed the highest sensitivity (67%) and specificity (68%), was defined post hoc as the cutoff for fentanyl consumption during postoperative 24 h ≥1000 µg. Conclusion: Our finding suggests that the SPI response to nociceptive stimuli during surgery is closely related to the degree of patient postoperative pain and opioid requirements. This information may be used to provide proper intraoperative analgesia and individual postoperative pain management.

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EEG-derived pain threshold index for prediction of postoperative pain in patients undergoing laparoscopic urological surgery: a comparison with surgical pleth index

Wang

Deng

Zhou

et al. 2020

J Clin Monit Comput

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Prediction of postoperative pain and analgesic requirements using surgical pleth index: a observational study

Cited by 8 publications

References 19 publications

Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis

Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis

<p>Prediction of Postoperative Pain and Opioid Consumption Using Intraoperative Surgical Pleth Index After Surgical Incision: An Observational Study</p>

EEG-derived pain threshold index for prediction of postoperative pain in patients undergoing laparoscopic urological surgery: a comparison with surgical pleth index

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