European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of the Surgical Pleth Index with autonomic nervous system modulation on cardiac activity during general anaesthesia.
Surgical plethysmographic index (SPI) has been proposed as a tool to measure the nociception/antinociception balance during general anaesthesia. Untreated nociception may increase sympathetic tone, but the relationship between SPI and the autonomic nervous system (ANS) is poorly understood. ⋯ In the context of a balanced general anaesthesia in healthy patients undergoing laparoscopic abdominal surgery, ANS modulation seems to correlate with changes in SPI. Further studies are warranted to assess whether this may reflect a change in nociception/antinociception balance or a pharmacodynamic effect of remifentanil.
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Observational Study
Pain assessment in the postanaesthesia care unit using pupillometry: A cross-sectional study after standard anaesthetic care.
Patients assess their own pain with a numerical rating scale (NRS). In the postanaesthesia care unit (PACU), NRS helps to determine and monitor analgesic administration, but is useless in patients who are unable to communicate. In non-PACU patients, acute pain increases pupillary diameter and pupillary light reflex amplitude (PLRA), the difference between pupillary diameter before and after light stimulation. ⋯ Acute postoperative pain is not associated with pupillary diameter or PLRA. Further research is required to develop tools to assess pain in the PACU.
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Letter Case Reports
Finger pulse oximetry detects an intense congestion: A case report.