Evaluation of the Intraoperative Perfusion Index for Correlation with Acute Postoperative Pain in Patients Undergoing Laparoscopic Colorectal Cancer Surgery.

Ji Hye Kwon,Joo Hyun Park,Jin Young Lee,Woo Seog Sim,Min Seok Oh,Kang Ha Jung,Hue Jung Park,Heui Jin Seon

doi:10.3390/jcm8091299

Abstract

Despite technical advancements in the perioperative management of cancer surgery, postoperative pain remains a significant clinical issue. We examined the diagnostic value of the intraoperative perfusion index for predicting acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed data for 105 patients who had undergone laparoscopic colorectal cancer surgery. Patients with pain scores <7 and ≥7 on a 10-point scale upon arrival in the postoperative anesthesia care unit (PACU) were categorized into the N and P groups, respectively. The perfusion index value was extracted prior to intubation, at the start and end of surgery, and after extubation. To minimize individual variance in the absolute value of the perfusion index, we calculated the perfusion index change ratio. A total of 98 patients were examined. Among them, 50 (51.0%) and 48 (49.0%) patients reported pain scores of <7 and ≥7 upon arrival at the PACU, respectively. Fentanyl consumption during the intraoperative and PACU periods was significantly higher in Group P than in Group N (p < 0.001). The perfusion index change ratios did not significantly differ between the groups. The intraoperative perfusion index change ratios do not correlate with acute postoperative pain following laparoscopic colorectal cancer surgery.

Highlights

Despite technical advancements in the perioperative management of cancer surgery, postoperative pain remains a significant clinical issue [1]
We examined whether the intraoperative perfusion index (PI) values correlate with acute postoperative pain levels in patients undergoing laparoscopic colorectal cancer surgery
The PI and bispectral index (BIS) change ratios are presented as the means ± standard deviations (SD) (Table 2)

Summary

Introduction

Despite technical advancements in the perioperative management of cancer surgery, postoperative pain remains a significant clinical issue [1]. Korhonen and colleagues [8] reported that skin vasomotor responses and photoplethysmography amplitudes are associated with nociception during general anesthesia. This association may be affected by several confounding factors such as physiological variables (e.g., hypothermia, hypovolemia, and circulatory conditions) or pharmacological treatments (e.g., anesthetics, analgesics, and vasoactive drugs) [8]. We examined whether the intraoperative PI values correlate with acute postoperative pain levels in patients undergoing laparoscopic colorectal cancer surgery. We focused on colorectal cancer surgery for this study because it may induce complex postoperative pain, including somatic and visceral pain from surgical incisions affecting intra-abdominal structures and neuropathic pain due to stimulation of the pelvic plexus [11]

Methods

Results

Conclusion