Two different methods to assess sympathetic tone during general anesthesia lead to different findings.
Noxious stimulation influences the autonomic nervous system activity. Sympathetic tone monitoring is currently used to assess the adequacy of the balance between nociception and anti-nociception during general anesthesia. The Surgical Plethysmographic Index (SPI) and the EBMi software (Custos©) are...
| Published in: | Journal of Clinical Monitoring & Computing Vol. 33; no. 3; pp. 463 - 470 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
Springer Nature
Jun2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136223994&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136223994 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2019 vid: 33 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 136223994 136223994 NLM29943169 136223994 10.1007/s10877-018-0175-7 NLM29943169 136223994 ppf: 463 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Two different methods to assess sympathetic tone during general anesthesia lead to different findings. aug: au: Defresne, Aline Harrison, Michael Clement, François Barvais, Luc Bonhomme, Vincent affil: GIGA – Consciousness, Anesthesia and Intensive Care Medicine Laboratory, University and CHU University Hospital of Liege, Liege, Belgium sug: subj: Sympathetic Nervous System Physiopathology Anesthesia, General Intraoperative Monitoring Methods Plethysmography Methods Blood Pressure Drug Effects Autonomic Nervous System Equipment Design Retrospective Design Software Heart Rate Anesthetics, Intravenous Pharmacodynamics Propofol Pharmacodynamics Algorithms Anesthetics Perception Human Validation Studies Comparative Studies Evaluation Research Multicenter Studies Questionnaires Scales ab: Noxious stimulation influences the autonomic nervous system activity. Sympathetic tone monitoring is currently used to assess the adequacy of the balance between nociception and anti-nociception during general anesthesia. The Surgical Plethysmographic Index (SPI) and the EBMi software (Custos©) are commercial devices that use different algorithms to measure it. We aimed at determining whether those devices provide similar information during routine surgical procedures under general anesthesia. Data acquired during a previously published study in patients undergoing surgery under general anesthesia were retrospectively analyzed and passed through the EBMi software. The occurrence of EBMi alarms of increased sympathetic tone was compared to the occurrence of SPI values ≥ 60, a commonly recommended intraoperative SPI threshold. Trends in classical parameters of sympathetic tone during the 5 min preceding a SPI ≥ 60, namely blood pressure, heart rate, and plethysmographic pulse amplitude were assessed. SPI ≥ 60 episodes (n = 307) were more frequent than EBMi alerts (n = 240). Approximately 70% of EBMi alerts occurred during periods where the SPI was below 60. Among all episodes of SPI ≥ 60, absence of any EBMi alerts was much more frequent than the inverse. A majority, but not all SPI ≥ 60 episodes were consistently preceded by an increase in heart rate and/or a decrease in pulse amplitude. Blood pressure did not significantly change before SPI ≥ 60. Longer SPI ≥ 60 episodes were associated with lower anti-nociception anesthetic regimen. Different methods of sympathetic tone assessment during general anesthesia provide conflicting information. Prospective studies should be undertaken to clarify the clinical indications of both techniques. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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