Article (Scientific journals)
Two different methods to assess sympathetic tone during general anesthesia lead to different findings.
DEFRESNE, Aline; Harrison, Michael; Clement, Francois et al.
2019In Journal of Clinical Monitoring and Computing
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Keywords :
Autonomic nervous system; General anesthesia; Monitoring; Sympathetic tone
Abstract :
[en] 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(c)) 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.
Disciplines :
Anesthesia & intensive care
Author, co-author :
DEFRESNE, Aline  ;  Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation
Harrison, Michael
Clement, Francois
Barvais, Luc
BONHOMME, Vincent  ;  Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Service d'anesthésie - réanimation
Language :
English
Title :
Two different methods to assess sympathetic tone during general anesthesia lead to different findings.
Publication date :
2019
Journal title :
Journal of Clinical Monitoring and Computing
ISSN :
1387-1307
eISSN :
1573-2614
Publisher :
Kluwer Academic Publishers, Netherlands
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 28 June 2018

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