Abstract
BackgroundThe 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.MethodsWe 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.ResultsSPI 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.ConclusionsDexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli.Trial registrationChinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450, Registered 16 October, 2016.
Highlights
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
Patients were selected if they met the following criteria: clinical diagnosis of lung cancer limited to one lung, age 18–75 years, body mass index (BMI) 18–30 kg/m2, and American Society of Anesthesiologists physical status grade (ASA) I-II
One patient was excluded because of a significant decrease in heart rate (HR) (< 45 bpm) during surgery in the dexmedetomidine group, and three patients were excluded in the normal saline group
Summary
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. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery. Video-assisted thoracoscopic surgery (VATS) is being performed more frequently. Thoracoscopic lung lobectomy is less traumatic than open thoracotomy, patients still experience significant pain [1, 2]. The Surgical Pleth Index (SPI), formerly, the “surgical. SPI ranges from 0 to 100, and higher values indicate stronger stimuli during surgery [7]. Studies show that dexmedetomidine attenuates surgical stress responses in patients undergoing surgery [10, 11], and, as an adjunctive analgesic, can be safely and effectively used during surgery. Because of its characteristics, some anesthesiologists in clinical practice use dexmedetomidine as an auxiliary drug during anesthesia; other anesthesiologists do not use this drug because of a fear of significantly decreasing HR, and they choose other sedative drugs, such as midazolam
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