Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lun
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(2020) 15:296
RESEARCH ARTICLE
Open Access
Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lung lobectomy Yu-Lan Wang†, Xiao-Qi Kong† and Fu-Hai Ji*
Abstract Background: The Surgical Pleth Index (SPI) is a monitoring method that reflects painful stimuli during general anesthesia, and dexmedetomidine is an analgesic adjuvant with an opioid-sparing effect. But up to now, it is still unclear whether dexmedetomidine has any influence on SPI. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery. Methods: We enrolled 94 patients who underwent video-assisted thoracoscopic lung lobectomy. Patients were randomly assigned to a dexmedetomidine group (dexmedetomidine: 0.8 μg/kg administered for 10 min before anesthesia) or normal saline group (equal volume of normal saline). SPI and vital signs were recorded. The number rating scale (NRS) pain score was also evaluated. Results: SPI values were significantly lower in the dexmedetomidine group than in the normal saline group at intubation and at discharge from the postanesthesia care unit. Compared with the normal saline group, mean arterial pressure and heart rate were both significantly lower in the dexmedetomidine group at intubation. Heart rate was lower at skin incision in the dexmedetomidine group. The NRS score in the normal saline group was noticeably higher vs. the dexmedetomidine group at discharge from the postanesthesia care unit. Conclusions: Dexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli. Trial registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450, Registered 16 October, 2016. Keywords: Surgical Pleth index, Dexmedetomidine, Number rating scale, Thoracoscopic lung lobectomy
Background Video-assisted thoracoscopic surgery (VATS) is being performed more frequently. However, although thoracoscopic lung lobectomy is less traumatic than open thoracotomy, patients still experience significant pain [1, 2]. The Surgical Pleth Index (SPI), formerly, the “surgical * Correspondence: [email protected] † Yu-Lan Wang and Xiao-Qi Kong contributed equally to this work. Department of Anesthesia Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, Jiangsu, China
stress index”, is a monitoring method for patients’ responses to surgical stimulation without injury. SPI can be used to monitor patients’ hemodynamic responses during general anesthesia because SPI reflects the increased sympathetic activity of the patient in response to painful (nociceptive) stimuli. The SPI value is obtained from photoplethysmographic amplitude (PPGA) and heart rate (HR) data from pulse oximetry measurements [3, 4]. Studies demonstrate that SPI can detect the balance between nociceptor activation and analgesia better
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License
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