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Effect of laryngeal mask airway insertion on parameters derived from catacrotic phase of photoplethysmography under different concentrations of remifentanil
IEEE Journal of Translational Engineering in Health and Medicine ( IF 3.4 ) Pub Date : 2020-01-01 , DOI: 10.1109/jtehm.2020.3017368
Wanlin Chen 1, 2 , Ying Feng 3 , Xinzhong Chen 2, 3 , Feng Jiang 1, 2 , Jiajun Miao 1, 2 , Shali Chen 1, 2 , Hang Chen 1, 2, 4
Affiliation  

Background: Some parameters have been extracted from photoplethysmography (PPG) with a good relativity with nociception, but without encouraging results in qualifying the balance of nociception-anti-nociception (NAN). The features of PPG have not been thoroughly depicted and more prospective univariate parameters deserve to be explored. The aim of this study was to investigate the ability of parameters derived from catacrotic phase of PPG to grade the level of analgesia. Methods: 45 patients with ASA I or II were randomized to receive a remifentanil effect-compartment target controlled infusion (Ceremi) of 0, 1, or 3 ng/ml, and a propofol effect-compartment target controlled infusion to maintain an acceptable level of hypnosis with state entropy (SE) at 40~60. Laryngeal mask airway (LMA) insertion was applied as a noxious stimulus. Five diastole-related parameters, namely diastolic interval (DI), diastolic slope (DS), the minimum slope during catacrotic phase (DSmin), the interval between DSmin and its nearest trough (DTI), and area difference ratio (ADR), were extracted. Pulse beat interval (PBI) was calculated as a reference parameter. Results: LMA insertion elicited a significant variation in all parameters except ADR during Ceremi of 0 and 1 ng/ml. Compared to PBI (prediction probability ( $\text{P}_{\text {K}}$ ) = 0.796), the parameters of DI, DS, and DTI presented a better consistence with the level of anti-nociceptive medication, with $\text{P}_{\text {K}}$ of 0.825, 0.822, and 0.822 respectively. Conclusion: The features extracted from catacrotic phase of PPG, including DI, DS, and DTI, could provide a promising potential to qualify the balance of NAN.

中文翻译:

喉罩气道插入对不同浓度瑞芬太尼下光体积描记法的衰变期参数的影响

背景:从光电容积脉搏波 (PPG) 中提取的一些参数与伤害感受具有良好的相关性,但在确定伤害感受-抗伤害感受 (NAN) 的平衡方面没有令人鼓舞的结果。PPG 的特征还没有被彻底描述,更多的前瞻性单变量参数值得探索。本研究的目的是调查从 PPG 的坏死阶段得出的参数对镇痛水平进行分级的能力。方法:45 名 ASA I 或 II 患者随机接受 0、1 或 3 ng/ml 的瑞芬太尼效应区目标控制输注 (Ceremi) 和丙泊酚效应区目标控制输注以维持可接受的水平状态熵(SE)在 40~60 的催眠。喉罩气道 (LMA) 插入被用作有害刺激。五个与舒张相关的参数,即舒张间隔(DI)、舒张斜率(DS)、衰变期最小斜率(DSmin)、DSmin与其最近波谷之间的间隔(DTI)和面积差比(ADR),分别为提取。计算脉搏间隔 (PBI) 作为参考参数。结果:在 0 和 1 ng/ml 的 Ceremi 期间,LMA 插入引起了除 ADR 之外的所有参数的显着变化。与PBI(预测概率( $\text{P}_{\text {K}}$ )= 0.796)相比,DI、DS、DTI参数与抗伤害药物水平的一致性更好, $\text{P}_{\text {K}}$ 分别为 0.825、0.822 和 0.822。结论:从 PPG 的坏死阶段提取的特征,包括 DI、DS 和 DTI,可以提供有希望的潜力来限定 NAN 的平衡。
更新日期:2020-01-01
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