Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability

Matti Huiku, Mark van Gils, Ilkka Korhonen, Minna Kymäläinen, Petri Kärkäs, Panu Takala, Kimmo Uutela, Arvi Yli-Hankala

Research output: Chapter in Book/Report/Conference proceedingConference article in proceedingsScientificpeer-review

Abstract

Abstract: Stress free anaesthesia can be providedwith timely and adequate administration of hypnotic and analgesic drugs. Our goal was to develop a measure for the surgical stress in a patient. 60 patients were anesthetized with propofol and remifentanil target controlled infusion with rocuronium paralysis. We recorded physiological parameter data and calculated off-line heart rate (RRI) and plethysmographic amplitude (PPGA) variability parameters. The beat-to-beat RRI and PPGA time series were investigated in different time scales. The original time series were normalized using histogram transformation, which reduces the inter-patient variability by adjusting the measured parameter values to the same fixed range and distribution in all patients. Sympathovagal ratio and estimates for the irregularity of the respiratory modulation were calculated synchronized to artificial ventilation. These parameters were regressed with the estimated severity of surgical stimulation, remifentanil effect site concentration, and their combination. The parameters were ranked according to the mean regression coefficient divided by the standard deviation over the patient dataset. The best performing parameters were the normalized RRI and PPGA, which are the promising candidates for a surgical stress index.
Original languageEnglish
Title of host publicationProceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005
Editioncd
Publication statusPublished - 2005
MoE publication typeA4 Article in a conference publication
Event3rd European Medical and Biological Engineering Conference, EMBEC'05 - Prague, Czech Republic
Duration: 20 Nov 200525 Nov 2005

Publication series

SeriesIFMBE Proceedings
Volume11
ISSN1680-0737

Conference

Conference3rd European Medical and Biological Engineering Conference, EMBEC'05
Abbreviated titleEMBEC
CountryCzech Republic
CityPrague
Period20/11/0525/11/05

Fingerprint

Heart Rate
Propofol
Hypnotics and Sedatives
Paralysis
Analgesics
Anesthesia
remifentanil

Keywords

  • analgesia
  • depth of anaesthesia
  • heart-rate variability

Cite this

Huiku, M., van Gils, M., Korhonen, I., Kymäläinen, M., Kärkäs, P., Takala, P., ... Yli-Hankala, A. (2005). Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability. In Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005 (cd ed.). IFMBE Proceedings, Vol.. 11
Huiku, Matti ; van Gils, Mark ; Korhonen, Ilkka ; Kymäläinen, Minna ; Kärkäs, Petri ; Takala, Panu ; Uutela, Kimmo ; Yli-Hankala, Arvi. / Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability. Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005. cd. ed. 2005. (IFMBE Proceedings, Vol. 11).
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abstract = "Abstract: Stress free anaesthesia can be providedwith timely and adequate administration of hypnotic and analgesic drugs. Our goal was to develop a measure for the surgical stress in a patient. 60 patients were anesthetized with propofol and remifentanil target controlled infusion with rocuronium paralysis. We recorded physiological parameter data and calculated off-line heart rate (RRI) and plethysmographic amplitude (PPGA) variability parameters. The beat-to-beat RRI and PPGA time series were investigated in different time scales. The original time series were normalized using histogram transformation, which reduces the inter-patient variability by adjusting the measured parameter values to the same fixed range and distribution in all patients. Sympathovagal ratio and estimates for the irregularity of the respiratory modulation were calculated synchronized to artificial ventilation. These parameters were regressed with the estimated severity of surgical stimulation, remifentanil effect site concentration, and their combination. The parameters were ranked according to the mean regression coefficient divided by the standard deviation over the patient dataset. The best performing parameters were the normalized RRI and PPGA, which are the promising candidates for a surgical stress index.",
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Huiku, M, van Gils, M, Korhonen, I, Kymäläinen, M, Kärkäs, P, Takala, P, Uutela, K & Yli-Hankala, A 2005, Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability. in Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005. cd edn, IFMBE Proceedings, vol. 11, 3rd European Medical and Biological Engineering Conference, EMBEC'05, Prague, Czech Republic, 20/11/05.

Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability. / Huiku, Matti; van Gils, Mark; Korhonen, Ilkka; Kymäläinen, Minna; Kärkäs, Petri; Takala, Panu; Uutela, Kimmo; Yli-Hankala, Arvi.

Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005. cd. ed. 2005. (IFMBE Proceedings, Vol. 11).

Research output: Chapter in Book/Report/Conference proceedingConference article in proceedingsScientificpeer-review

TY - GEN

T1 - Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability

AU - Huiku, Matti

AU - van Gils, Mark

AU - Korhonen, Ilkka

AU - Kymäläinen, Minna

AU - Kärkäs, Petri

AU - Takala, Panu

AU - Uutela, Kimmo

AU - Yli-Hankala, Arvi

PY - 2005

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N2 - Abstract: Stress free anaesthesia can be providedwith timely and adequate administration of hypnotic and analgesic drugs. Our goal was to develop a measure for the surgical stress in a patient. 60 patients were anesthetized with propofol and remifentanil target controlled infusion with rocuronium paralysis. We recorded physiological parameter data and calculated off-line heart rate (RRI) and plethysmographic amplitude (PPGA) variability parameters. The beat-to-beat RRI and PPGA time series were investigated in different time scales. The original time series were normalized using histogram transformation, which reduces the inter-patient variability by adjusting the measured parameter values to the same fixed range and distribution in all patients. Sympathovagal ratio and estimates for the irregularity of the respiratory modulation were calculated synchronized to artificial ventilation. These parameters were regressed with the estimated severity of surgical stimulation, remifentanil effect site concentration, and their combination. The parameters were ranked according to the mean regression coefficient divided by the standard deviation over the patient dataset. The best performing parameters were the normalized RRI and PPGA, which are the promising candidates for a surgical stress index.

AB - Abstract: Stress free anaesthesia can be providedwith timely and adequate administration of hypnotic and analgesic drugs. Our goal was to develop a measure for the surgical stress in a patient. 60 patients were anesthetized with propofol and remifentanil target controlled infusion with rocuronium paralysis. We recorded physiological parameter data and calculated off-line heart rate (RRI) and plethysmographic amplitude (PPGA) variability parameters. The beat-to-beat RRI and PPGA time series were investigated in different time scales. The original time series were normalized using histogram transformation, which reduces the inter-patient variability by adjusting the measured parameter values to the same fixed range and distribution in all patients. Sympathovagal ratio and estimates for the irregularity of the respiratory modulation were calculated synchronized to artificial ventilation. These parameters were regressed with the estimated severity of surgical stimulation, remifentanil effect site concentration, and their combination. The parameters were ranked according to the mean regression coefficient divided by the standard deviation over the patient dataset. The best performing parameters were the normalized RRI and PPGA, which are the promising candidates for a surgical stress index.

KW - analgesia

KW - depth of anaesthesia

KW - heart-rate variability

M3 - Conference article in proceedings

T3 - IFMBE Proceedings

BT - Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005

ER -

Huiku M, van Gils M, Korhonen I, Kymäläinen M, Kärkäs P, Takala P et al. Assessment of surgical stress using heart rate and plethysmographic pulse wave amplitude variability. In Proceedings of the 3rd European Medical and Biological Engineering Conference, IFMBE Proceedings, 2005. cd ed. 2005. (IFMBE Proceedings, Vol. 11).