الفهرس 
Participants and MethodsOnly 14 pages are availabe for public view
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Abstract
Background: The Surgical Pleth Index (SPI) has been introduced to monitor
intraoperative pain under general anesthesia. So our study was to determine the
optimum time to measure intraoperative SPI, which correlates better with postoperative
pain.
Methods: This prospective observational blind study collected data from 99 female
patients scheduled for elective abdominal hysterectomy under general anesthesia. SPI
will be recorded 5 minutes after skin incision and 10 minutes before recovery. After
recovery, Upon ability to communicate, all patients will be asked to quantify their pain
level. The primary outcome is determining which SPI measurement is more correlated
with postoperative pain. The secondary outcomes are to evaluate the correlation
between the SPI measurements and opioid consumption in the first postoperative 24
hours and define the cut-off value of SPI measurements.
Results: In the current study we found that, there was a statistically significant
correlation between SPI 10 min before recovery and highest NRS (r=0.55, p-value
<0.001). The cut-off value, with highest sensitivity and specificity, of SPI 10 minutes
before recovery to differentiate between moderate and severe pain was 57. On the other
hand, no significant correlation was observed between SPI 5 min after skin incision and
the highest NRS. Also, SPI 10 minutes was significantly correlated with postoperative
tramadol consumption; however, SPI 5 minutes was not.
Conclusion: SPI is a good indicator for nociception. Pre-arousal SPI score is more
correlated with postoperative pain scores and opioid consumption than SPI score after
skin incision. Also, SPI 10 minutes before recovery value of 57 was the cut-off value,
with the highest sensitivity and specificity, to differentiate between moderate and severe
pain.