Abstract
Methods: Ninety-five patients, ASA I or II, were randomly assigned to five groups [Group 1: bispectral index (BIS) (range) 40–50, effect site remifentanil concentration 1 ng ml−1;Group 2: BIS 40–50, remifentanil 2 ng ml−1; Group 3: BIS 40–50, remifentanil 4 ng ml−1; Group 4: BIS 25–35, remifentanil 2 ng ml−1; Group 5: BIS 55–65, remifentanil 2 ng ml−1]. A 60 mA tetanic stimulus was applied for 5 s on the ulnar nerve. From the digitized pulse oximeter wave recorded on a laptop computer, linear and non-linear parameters of PPG variation during the 60 s period after stimulation were computed. The haemodynamic response to subsequent orotracheal intubation was recorded. The PPG variation was compared between groups and between responders and non-responders to intubation (anova). Variables independently predicting the response were determined by logistic regression.
Results: The probability of a response to tracheal intubation was 0.77, 0.47, 0.05, 0.18 and 0.52 in Groups 1–5, respectively (P<0.03). The PPG variability was significantly higher in responders than in non-responders but it did not improve the prediction of the response to tracheal intubation based on BIS level and effect site remifentanil concentration.
Conclusion: Tetanic stimulation induced PPG variation does not reflect the analgesic state in a wide clinical range of surgical anaesthesia.
| Original language | English |
|---|---|
| Pages (from-to) | 323-329 |
| Journal | British Journal of Anaesthesia |
| Volume | 96 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2006 |
| MoE publication type | A1 Journal article-refereed |
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Keywords
- anaesthesia
- depth of anaesthesia
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Stimulation induced variability of pulse plethysmography does not discriminate responsiveness to intubation. / Luginbühl, M. (Corresponding Author); Rüfenacht, M.; Korhonen, Ilkka; van Gils, Mark; Jakob, S.; Petersen-Felix, S.
In: British Journal of Anaesthesia, Vol. 96, No. 3, 2006, p. 323-329.Research output: Contribution to journal › Article › Scientific › peer-review
TY - JOUR
T1 - Stimulation induced variability of pulse plethysmography does not discriminate responsiveness to intubation
AU - Luginbühl, M.
AU - Rüfenacht, M.
AU - Korhonen, Ilkka
AU - van Gils, Mark
AU - Jakob, S.
AU - Petersen-Felix, S.
PY - 2006
Y1 - 2006
N2 - Background: Hypnotic depth but not haemodynamic response to painful stimulation can be measured with various EEG-based anaesthesia monitors. We evaluated the variation of pulse plethysmography amplitude induced by an electrical tetanic stimulus (PPG variation) as a potential measure for analgesia and predictor of haemodynamic responsiveness during general anaesthesia.Methods: Ninety-five patients, ASA I or II, were randomly assigned to five groups [Group 1: bispectral index (BIS) (range) 40–50, effect site remifentanil concentration 1 ng ml−1;Group 2: BIS 40–50, remifentanil 2 ng ml−1; Group 3: BIS 40–50, remifentanil 4 ng ml−1; Group 4: BIS 25–35, remifentanil 2 ng ml−1; Group 5: BIS 55–65, remifentanil 2 ng ml−1]. A 60 mA tetanic stimulus was applied for 5 s on the ulnar nerve. From the digitized pulse oximeter wave recorded on a laptop computer, linear and non-linear parameters of PPG variation during the 60 s period after stimulation were computed. The haemodynamic response to subsequent orotracheal intubation was recorded. The PPG variation was compared between groups and between responders and non-responders to intubation (anova). Variables independently predicting the response were determined by logistic regression.Results: The probability of a response to tracheal intubation was 0.77, 0.47, 0.05, 0.18 and 0.52 in Groups 1–5, respectively (P<0.03). The PPG variability was significantly higher in responders than in non-responders but it did not improve the prediction of the response to tracheal intubation based on BIS level and effect site remifentanil concentration.Conclusion: Tetanic stimulation induced PPG variation does not reflect the analgesic state in a wide clinical range of surgical anaesthesia.
AB - Background: Hypnotic depth but not haemodynamic response to painful stimulation can be measured with various EEG-based anaesthesia monitors. We evaluated the variation of pulse plethysmography amplitude induced by an electrical tetanic stimulus (PPG variation) as a potential measure for analgesia and predictor of haemodynamic responsiveness during general anaesthesia.Methods: Ninety-five patients, ASA I or II, were randomly assigned to five groups [Group 1: bispectral index (BIS) (range) 40–50, effect site remifentanil concentration 1 ng ml−1;Group 2: BIS 40–50, remifentanil 2 ng ml−1; Group 3: BIS 40–50, remifentanil 4 ng ml−1; Group 4: BIS 25–35, remifentanil 2 ng ml−1; Group 5: BIS 55–65, remifentanil 2 ng ml−1]. A 60 mA tetanic stimulus was applied for 5 s on the ulnar nerve. From the digitized pulse oximeter wave recorded on a laptop computer, linear and non-linear parameters of PPG variation during the 60 s period after stimulation were computed. The haemodynamic response to subsequent orotracheal intubation was recorded. The PPG variation was compared between groups and between responders and non-responders to intubation (anova). Variables independently predicting the response were determined by logistic regression.Results: The probability of a response to tracheal intubation was 0.77, 0.47, 0.05, 0.18 and 0.52 in Groups 1–5, respectively (P<0.03). The PPG variability was significantly higher in responders than in non-responders but it did not improve the prediction of the response to tracheal intubation based on BIS level and effect site remifentanil concentration.Conclusion: Tetanic stimulation induced PPG variation does not reflect the analgesic state in a wide clinical range of surgical anaesthesia.
KW - anaesthesia
KW - depth of anaesthesia
U2 - 10.1093/bja/aei315
DO - 10.1093/bja/aei315
M3 - Article
VL - 96
SP - 323
EP - 329
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 3
ER -