Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis

doi:10.3390/diagnostics12092167

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Title:	Elevated Surgical Pleth Index at the End of Surgery Is Associated with Postoperative Moderate-to-Severe Pain: A Systematic Review and Meta-Analysis
Authors:	Hung, Kuo-Chuan Huang, Yen-Ta Kuo, Jinn-Rung Hsu, Chih-Wei Yew, Ming Chen, Jen-Yin Lin, Ming-Chung Chen, I-Wen Sun, Cheuk-Kwan
Contributors:	Chi Mei Hospital Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy & Science National Cheng Kung University National Cheng Kung University Hospital Chi Mei Hospital Chang Gung Memorial Hospital Chang Gung University E-Da Hospital I Shou University
Keywords:	hospitalized-patients stress index prediction satisfaction variability nociception anesthesia experience management accuracy
Date:	2022
Issue Date:	2023-12-11 13:58:36 (UTC+8)
Publisher:	MDPI
Abstract:	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, p = 0.002, I-2 = 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-2 = 29.01%) and a specificity of 0.58 (95% CI: 0.39-0.74; I-2 = 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.
Relation:	Diagnostice, v.12, n.9, Article 2167
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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