Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis
Despite acceptance of the surgical pleth index (SPI) for monitoring the intraoperative balance between noxious stimulation and anti-nociception under general anesthesia, its efficacy for predicting postoperative moderate-to-severe pain remains unclear. We searched electronic databases (e.g., Google...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2167 |
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| author | Kuo-Chuan Hung Yen-Ta Huang Jinn-Rung Kuo Chih-Wei Hsu Ming Yew Jen-Yin Chen Ming-Chung Lin I-Wen Chen Cheuk-Kwan Sun |
| author_facet | Kuo-Chuan Hung Yen-Ta Huang Jinn-Rung Kuo Chih-Wei Hsu Ming Yew Jen-Yin Chen Ming-Chung Lin I-Wen Chen Cheuk-Kwan Sun |
| author_sort | Kuo-Chuan Hung |
| collection | DOAJ |
| description | Despite acceptance of the surgical pleth index (SPI) for monitoring the intraoperative balance between noxious stimulation and anti-nociception under general anesthesia, its efficacy for predicting postoperative moderate-to-severe pain remains unclear. We searched electronic databases (e.g., Google Scholar, MEDLINE, Cochrane Library, and EMBASE) to identify articles focusing on associations of SPI at the end of surgery with immediate moderate-to-severe pain in the postanesthesia care unit from inception to 7 July 2022. A total of six observational studies involving 756 adults published between 2016 and 2020 were eligible for quantitative syntheses. Pooled results revealed higher values of SPI in patients with moderate-to-severe pain than those without (mean difference: 7.82, 95% CI: 3.69 to 11.95, <i>p</i> = 0.002, I<sup>2</sup> = 46%). In addition, an elevated SPI at the end of surgery was able to predict moderate-to-severe pain with a sensitivity of 0.71 (95% confidence interval (CI): 0.65–0.77; I<sup>2</sup> = 29.01%) and a specificity of 0.58 (95% CI: 0.39–0.74; I<sup>2</sup> = 79.31%). The overall accuracy based on the summary receiver operating characteristic (sROC) curve was 0.72. In conclusion, this meta-analysis highlighted the feasibility of the surgical pleth index to predict postoperative moderate-to-severe pain immediately after surgery. Our results from a limited number of studies warrant further investigations for verification. |
| first_indexed | 2024-03-10T00:17:08Z |
| format | Article |
| id | doaj.art-93e64c25f771431ba9c91016315bff28 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:17:08Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-93e64c25f771431ba9c91016315bff282023-11-23T15:49:48ZengMDPI AGDiagnostics2075-44182022-09-01129216710.3390/diagnostics12092167Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-AnalysisKuo-Chuan Hung0Yen-Ta Huang1Jinn-Rung Kuo2Chih-Wei Hsu3Ming Yew4Jen-Yin Chen5Ming-Chung Lin6I-Wen Chen7Cheuk-Kwan Sun8Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, TaiwanDepartment of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70101, TaiwanDepartment of Neurosurgery, Chi Mei Medical Center, Tainan City 71004, TaiwanDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, TaiwanDepartment of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City 73657, TaiwanDepartment of Emergency Medicine, E-Da Hospital, Kaohsiung City 82445, TaiwanDespite acceptance of the surgical pleth index (SPI) for monitoring the intraoperative balance between noxious stimulation and anti-nociception under general anesthesia, its efficacy for predicting postoperative moderate-to-severe pain remains unclear. We searched electronic databases (e.g., Google Scholar, MEDLINE, Cochrane Library, and EMBASE) to identify articles focusing on associations of SPI at the end of surgery with immediate moderate-to-severe pain in the postanesthesia care unit from inception to 7 July 2022. A total of six observational studies involving 756 adults published between 2016 and 2020 were eligible for quantitative syntheses. Pooled results revealed higher values of SPI in patients with moderate-to-severe pain than those without (mean difference: 7.82, 95% CI: 3.69 to 11.95, <i>p</i> = 0.002, I<sup>2</sup> = 46%). In addition, an elevated SPI at the end of surgery was able to predict moderate-to-severe pain with a sensitivity of 0.71 (95% confidence interval (CI): 0.65–0.77; I<sup>2</sup> = 29.01%) and a specificity of 0.58 (95% CI: 0.39–0.74; I<sup>2</sup> = 79.31%). The overall accuracy based on the summary receiver operating characteristic (sROC) curve was 0.72. In conclusion, this meta-analysis highlighted the feasibility of the surgical pleth index to predict postoperative moderate-to-severe pain immediately after surgery. Our results from a limited number of studies warrant further investigations for verification.https://www.mdpi.com/2075-4418/12/9/2167surgical pleth indexpainpostanesthesia care unitsummary receiver operating characteristicmeta-analysis |
| spellingShingle | Kuo-Chuan Hung Yen-Ta Huang Jinn-Rung Kuo Chih-Wei Hsu Ming Yew Jen-Yin Chen Ming-Chung Lin I-Wen Chen Cheuk-Kwan Sun Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis Diagnostics surgical pleth index pain postanesthesia care unit summary receiver operating characteristic meta-analysis |
| title | Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis |
| title_full | Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis |
| title_fullStr | Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis |
| title_short | Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis |
| title_sort | elevated surgical pleth index at the end of surgery is associated with postoperative moderate to severe pain a systematic review and meta analysis |
| topic | surgical pleth index pain postanesthesia care unit summary receiver operating characteristic meta-analysis |
| url | https://www.mdpi.com/2075-4418/12/9/2167 |
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