Authors : Shivanand Hulakund, Mahindra B Kalashetty, Manuja H S, Dinesh Naik, Vidyashree Jivali
DOI : 10.18231/j.ijca.2020.045
Volume : 7
Issue : 2
Year : 2020
Page No : 251-255
Background and Aims: The Surgical Pleth Index (SPI) is a multivariate index derived noninvasively from
finger plethysmographic signal. It has been demonstrated to correlate with surgical stress intensity. So,
we examined these beneficial effects of SPI guided anaesthesia to determine the amount of intraoperative
fentanyl consumption and haemodynamic stability in laparoscopic surgeries under general anaesthesia.
Methodology: After obtaining institutional ethical clearance and patient informed consent, A total of 100
Patients (20-65yrs) posted for laparoscopic surgeries under general anaesthesia were randomly allocated to
the SPI and conventional analgesia group (50 patients each). In SPI group, SPI value >50; In conventional
group, rise in heart rate(HR), mean arterial pressure (MAP) 20% above baseline were the criteria for
fentanyl administration. Fentanyl 0.5 mg/kg is administered in each group for an event persisting for 5
min. Intraoperative fentanyl consumption, hemodynamic stability and postoperative pain for 1 hour were
observed. Comparison analysis was performed for total intraoperative fentanyl consumption using t-test.
Correlation analysis performed using the Pearson test and p- value <0>
Results: Total intraoperative fentanyl consumption was lower in SPI group than in the conventional
group (108.3021.84 mg vs 125.7024.87 mg; p=0.0003) and it was statistically significant with good
haemodynamic stability. Postoperative pain scores were comparable in both the groups. The postoperative
fentanyl consumption in SPI group was 14.4 1.7 mg and in conventional group was 19.4 7.0 mg.
Conclusion: Compared with conventional analgesia, SPI guided analgesia resulted in lower intraoperative
fentanyl consumption and more stable haemodynamics.
Keywords: Analgesia, Surgical pleth index, Fentanyl.