Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lung lobectomy

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.

Effect of Dexmedetomidine For Thoracoscopic Surgery: A Meta-analysis of Randomized Controlled Trials

“…The six studies were published between 2016 and 2020, and the total sample size was 510. Dexmedetomidine was used before the anesthesia [7,15,22,23], or during surgery [16,17].…”

“…However, the e cacy of dexmedetomidine supplementation for thoracoscopic surgery has not been well established. Recently, several studies on the topic have been published, and the results were con icting [7,[15][16][17]. With accumulating evidence, we therefore perform a systematic review and meta-analysis of RCTs to investigate the analgesic e cacy of dexmedetomidine supplementation for thoracoscopic surgery.…”

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

“…Technologies/parameters used for monitoring the nociception-antinociception balance [59][60][61][62][63][64][65][66]. ANI -analgesia nociception index; qNOX index -index of nociception; qCON index -index of consciousness; SPI -Surgical Plethysmographic Index; NOL index -Nociception Level Index One of the most widely studied technologies is the analysis of hemodynamic changes and includes the evaluation of the normalized heart beat intervals (HBIs) and of the amplitude of the plethysmographic waves, both correlating with sympathetic and parasympathetic tones.…”

“…Table 2 summarizes a series of studies regarding the impact of monitoring techniques on the nociception-antinociception balance and on the clinical outcome of patients. Numerous studies have shown that opioid overdose during anesthesia is responsible for a series of adverse effects, such as increased recovery times and opioid induced hyperalgesia, and they also lead to hypotension, having a major impact on perioperative hemodynamic stability [66][67][68][69][70][71]. Won et al, have reported that using SPI monitoring during general anesthesia reduces opioid consumption, improves hemodynamic stability, and reduced postoperative recovery times [71].…”

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

“…Figure 1. Technologies/parameters used for monitoring the nociception-antinociception balance [59][60][61][62][63][64][65][66] One of the most widely studied technologies is the analysis of hemodynamic changes and includes the evaluation of the normalized heart beat intervals (HBIs) and of the amplitude of the plethysmographic waves, both correlating with sympathetic and parasympathetic tones. A higher sympathetic tone correlates with the intensity of the surgical stimuli and results in a suppressed plethysmographic amplitude (PPGA).…”