State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery

Arvi Yli-Hankala, Markku Rantanen, Ilkka Korhonen, Mark van Gils, Heidi Yppärilä-Wolters, Matti Huiku, Minna Kymäläinen, Panu Takala, Kimmo Uutela, Hanna Viertiö-Oja

Research output: Contribution to journalOther journal contributionScientific

Abstract

Background and Goal of Study. Today no numeric measures of nociception during general anaesthesia are available. In search of such readily useable measure both predictive characteristics of the drug effect and responses to surgical stimulation are needed. We analyzed the alterations of photoplethysmographic waveform amplitude (PPGA) and heart rate (HR) during changing surgical stimuli and different target site levels of remifentanil. Our purpose was to develop a State Index of Nociception (SN) based on PPGA and HR derived information, which could measure the adequacy of analgesia during general anaesthesia and surgery. Materials and Methods. Physiological parameters were measured from 53 female patients anaesthetized with propofol and remifentanil, and paralysed with rocuronium. Remifentanil target site concentration was adjusted to 1, 3, or 5 ng/ml during surgery. SN was used to explain the combination of stimulation and remifentanil effect site concentration. SN was correlated with stimulation and remifentanil for each patient and the significance was calculated using Wilcoxon sign rank test over the subjects . Results and Discussions. SN correlated positively with stimulation (median r=0.42, P<0.0001) and negatively with remifentanil level (median r=-0.33, P<0.0001). Median correlation with their difference was 0.50 (P<0.0001). High SN values indicated presence of noxious stimuli and low remifentanil levels. Conclusions. SN is sensitive to low analgesia levels during noxious stimulation, and provides information of the adequacy of anesthesia.
Original languageEnglish
Article numberA-111
Pages (from-to)31
JournalEuropean Journal of Anaesthesiology
Volume22
Publication statusPublished - 2005
MoE publication typeB1 Article in a scientific magazine
EventAnnual Meeting of the European Society of Anaesthesiology (Euroanaesthesia2005). Vienna, Austria, 28 - 31 May 2005 -
Duration: 1 Jan 2005 → …

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Nociception
Analgesia
General Anesthesia
Heart Rate
Propofol
Nonparametric Statistics
remifentanil
Anesthesia
Pharmaceutical Preparations

Cite this

Yli-Hankala, A., Rantanen, M., Korhonen, I., van Gils, M., Yppärilä-Wolters, H., Huiku, M., ... Viertiö-Oja, H. (2005). State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery. European Journal of Anaesthesiology, 22, 31. [A-111].
Yli-Hankala, Arvi ; Rantanen, Markku ; Korhonen, Ilkka ; van Gils, Mark ; Yppärilä-Wolters, Heidi ; Huiku, Matti ; Kymäläinen, Minna ; Takala, Panu ; Uutela, Kimmo ; Viertiö-Oja, Hanna. / State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery. In: European Journal of Anaesthesiology. 2005 ; Vol. 22. pp. 31.
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title = "State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery",
abstract = "Background and Goal of Study. Today no numeric measures of nociception during general anaesthesia are available. In search of such readily useable measure both predictive characteristics of the drug effect and responses to surgical stimulation are needed. We analyzed the alterations of photoplethysmographic waveform amplitude (PPGA) and heart rate (HR) during changing surgical stimuli and different target site levels of remifentanil. Our purpose was to develop a State Index of Nociception (SN) based on PPGA and HR derived information, which could measure the adequacy of analgesia during general anaesthesia and surgery. Materials and Methods. Physiological parameters were measured from 53 female patients anaesthetized with propofol and remifentanil, and paralysed with rocuronium. Remifentanil target site concentration was adjusted to 1, 3, or 5 ng/ml during surgery. SN was used to explain the combination of stimulation and remifentanil effect site concentration. SN was correlated with stimulation and remifentanil for each patient and the significance was calculated using Wilcoxon sign rank test over the subjects . Results and Discussions. SN correlated positively with stimulation (median r=0.42, P<0.0001) and negatively with remifentanil level (median r=-0.33, P<0.0001). Median correlation with their difference was 0.50 (P<0.0001). High SN values indicated presence of noxious stimuli and low remifentanil levels. Conclusions. SN is sensitive to low analgesia levels during noxious stimulation, and provides information of the adequacy of anesthesia.",
author = "Arvi Yli-Hankala and Markku Rantanen and Ilkka Korhonen and {van Gils}, Mark and Heidi Ypp{\"a}ril{\"a}-Wolters and Matti Huiku and Minna Kym{\"a}l{\"a}inen and Panu Takala and Kimmo Uutela and Hanna Vierti{\"o}-Oja",
note = "CA2: TTE5 CA: TTE Project code: T5SU00454",
year = "2005",
language = "English",
volume = "22",
pages = "31",
journal = "European Journal of Anaesthesiology",
issn = "0265-0215",
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Yli-Hankala, A, Rantanen, M, Korhonen, I, van Gils, M, Yppärilä-Wolters, H, Huiku, M, Kymäläinen, M, Takala, P, Uutela, K & Viertiö-Oja, H 2005, 'State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery', European Journal of Anaesthesiology, vol. 22, A-111, pp. 31.

State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery. / Yli-Hankala, Arvi; Rantanen, Markku; Korhonen, Ilkka; van Gils, Mark; Yppärilä-Wolters, Heidi; Huiku, Matti; Kymäläinen, Minna; Takala, Panu; Uutela, Kimmo; Viertiö-Oja, Hanna.

In: European Journal of Anaesthesiology, Vol. 22, A-111, 2005, p. 31.

Research output: Contribution to journalOther journal contributionScientific

TY - JOUR

T1 - State index of nociception correlates both with remifentanil concentration and level of painful stimulation during surgery

AU - Yli-Hankala, Arvi

AU - Rantanen, Markku

AU - Korhonen, Ilkka

AU - van Gils, Mark

AU - Yppärilä-Wolters, Heidi

AU - Huiku, Matti

AU - Kymäläinen, Minna

AU - Takala, Panu

AU - Uutela, Kimmo

AU - Viertiö-Oja, Hanna

N1 - CA2: TTE5 CA: TTE Project code: T5SU00454

PY - 2005

Y1 - 2005

N2 - Background and Goal of Study. Today no numeric measures of nociception during general anaesthesia are available. In search of such readily useable measure both predictive characteristics of the drug effect and responses to surgical stimulation are needed. We analyzed the alterations of photoplethysmographic waveform amplitude (PPGA) and heart rate (HR) during changing surgical stimuli and different target site levels of remifentanil. Our purpose was to develop a State Index of Nociception (SN) based on PPGA and HR derived information, which could measure the adequacy of analgesia during general anaesthesia and surgery. Materials and Methods. Physiological parameters were measured from 53 female patients anaesthetized with propofol and remifentanil, and paralysed with rocuronium. Remifentanil target site concentration was adjusted to 1, 3, or 5 ng/ml during surgery. SN was used to explain the combination of stimulation and remifentanil effect site concentration. SN was correlated with stimulation and remifentanil for each patient and the significance was calculated using Wilcoxon sign rank test over the subjects . Results and Discussions. SN correlated positively with stimulation (median r=0.42, P<0.0001) and negatively with remifentanil level (median r=-0.33, P<0.0001). Median correlation with their difference was 0.50 (P<0.0001). High SN values indicated presence of noxious stimuli and low remifentanil levels. Conclusions. SN is sensitive to low analgesia levels during noxious stimulation, and provides information of the adequacy of anesthesia.

AB - Background and Goal of Study. Today no numeric measures of nociception during general anaesthesia are available. In search of such readily useable measure both predictive characteristics of the drug effect and responses to surgical stimulation are needed. We analyzed the alterations of photoplethysmographic waveform amplitude (PPGA) and heart rate (HR) during changing surgical stimuli and different target site levels of remifentanil. Our purpose was to develop a State Index of Nociception (SN) based on PPGA and HR derived information, which could measure the adequacy of analgesia during general anaesthesia and surgery. Materials and Methods. Physiological parameters were measured from 53 female patients anaesthetized with propofol and remifentanil, and paralysed with rocuronium. Remifentanil target site concentration was adjusted to 1, 3, or 5 ng/ml during surgery. SN was used to explain the combination of stimulation and remifentanil effect site concentration. SN was correlated with stimulation and remifentanil for each patient and the significance was calculated using Wilcoxon sign rank test over the subjects . Results and Discussions. SN correlated positively with stimulation (median r=0.42, P<0.0001) and negatively with remifentanil level (median r=-0.33, P<0.0001). Median correlation with their difference was 0.50 (P<0.0001). High SN values indicated presence of noxious stimuli and low remifentanil levels. Conclusions. SN is sensitive to low analgesia levels during noxious stimulation, and provides information of the adequacy of anesthesia.

M3 - Other journal contribution

VL - 22

SP - 31

JO - European Journal of Anaesthesiology

JF - European Journal of Anaesthesiology

SN - 0265-0215

M1 - A-111

ER -