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Evaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study.

Abstract

We evaluated the performance of the Surgical Plethysmographic Index (SPI) and the Analgesia Nociception Index (ANI) as surrogate pain measures and determined their respective cut-off values for detecting pain in conscious postoperative patients. In total, 192 patients after elective surgery were enrolled. Baseline SPI and ANI data were acquired for 10 min in the operating room prior to surgery when the patients rated their pain as 0 on the numerical rating scale (NRS). Upon arrival in the post-anaesthesia care unit (PACU) after surgery, SPI and ANI data were recorded for 10 min. The means of the recorded data at OR and PACU were defined as the values representing baseline and postoperative pain, respectively. SPI and ANI data obtained from 189 patients were analysed, who were anesthetized with propofol (n = 149) or sevoflurane (n = 40). Remifentanil was continuously infused intraoperatively in all patients. The values of SPI and ANI were significantly different in conscious patients without (NRS = 0) and with pain (NRS > 0). The areas under the receiver operating curves for SPI and ANI were 0.73 (P < 0.0001) and 0.67 (P < 0.0001), respectively. The cut-off values for SPI and ANI in predicting postoperative pain were 44 (sensitivity: 84%, specificity: 53%) and 63 (sensitivity: 52%, specificity: 82%), respectively, which are different from those suggested by their respective manufacturers for use in intraoperative state under general anaesthesia. The cut-off values of SPI and ANI for detecting pain were similar regardless of the type of anesthesia.

Authors+Show Affiliations

Department of Anaesthesiology and Pain Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea.Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. jyounbang@gmail.com.Department of Anaesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea. Department of Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31628569

Citation

Lee, Joo-Hyun, et al. "Evaluation of Surgical Pleth Index and Analgesia Nociception Index as Surrogate Pain Measures in Conscious Postoperative Patients: an Observational Study." Journal of Clinical Monitoring and Computing, 2019.
Lee JH, Choi BM, Jung YR, et al. Evaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study. J Clin Monit Comput. 2019.
Lee, J. H., Choi, B. M., Jung, Y. R., Lee, Y. H., Bang, J. Y., & Noh, G. J. (2019). Evaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study. Journal of Clinical Monitoring and Computing, doi:10.1007/s10877-019-00399-5.
Lee JH, et al. Evaluation of Surgical Pleth Index and Analgesia Nociception Index as Surrogate Pain Measures in Conscious Postoperative Patients: an Observational Study. J Clin Monit Comput. 2019 Oct 18; PubMed PMID: 31628569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study. AU - Lee,Joo-Hyun, AU - Choi,Byung-Moon, AU - Jung,Yu-Ri, AU - Lee,Yong-Hun, AU - Bang,Ji-Yeon, AU - Noh,Gyu-Jeong, Y1 - 2019/10/18/ PY - 2019/06/24/received PY - 2019/10/05/accepted PY - 2019/10/20/entrez PY - 2019/10/20/pubmed PY - 2019/10/20/medline KW - Analgesia Nociception Index KW - Conscious KW - Pain KW - Performance KW - Surgical Pleth Index JF - Journal of clinical monitoring and computing JO - J Clin Monit Comput N2 - We evaluated the performance of the Surgical Plethysmographic Index (SPI) and the Analgesia Nociception Index (ANI) as surrogate pain measures and determined their respective cut-off values for detecting pain in conscious postoperative patients. In total, 192 patients after elective surgery were enrolled. Baseline SPI and ANI data were acquired for 10 min in the operating room prior to surgery when the patients rated their pain as 0 on the numerical rating scale (NRS). Upon arrival in the post-anaesthesia care unit (PACU) after surgery, SPI and ANI data were recorded for 10 min. The means of the recorded data at OR and PACU were defined as the values representing baseline and postoperative pain, respectively. SPI and ANI data obtained from 189 patients were analysed, who were anesthetized with propofol (n = 149) or sevoflurane (n = 40). Remifentanil was continuously infused intraoperatively in all patients. The values of SPI and ANI were significantly different in conscious patients without (NRS = 0) and with pain (NRS > 0). The areas under the receiver operating curves for SPI and ANI were 0.73 (P < 0.0001) and 0.67 (P < 0.0001), respectively. The cut-off values for SPI and ANI in predicting postoperative pain were 44 (sensitivity: 84%, specificity: 53%) and 63 (sensitivity: 52%, specificity: 82%), respectively, which are different from those suggested by their respective manufacturers for use in intraoperative state under general anaesthesia. The cut-off values of SPI and ANI for detecting pain were similar regardless of the type of anesthesia. SN - 1573-2614 UR - https://www.unboundmedicine.com/medline/citation/31628569/Evaluation_of_Surgical_Pleth_Index_and_Analgesia_Nociception_Index_as_surrogate_pain_measures_in_conscious_postoperative_patients:_an_observational_study_ L2 - https://doi.org/10.1007/s10877-019-00399-5 DB - PRIME DP - Unbound Medicine ER -