Evidence map›Paper›PMID 30916030›Full record

Observational studyBritish journal of anaesthesia2019

Surgical pleth index: prospective validation of the score to predict moderate-to-severe postoperative pain.

T Ledowski, M Schneider, M Gruenewald, R K Goyal, S R Teo, J Hruby

2 registry-linked trialsAbstract readObservational StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in British journal of anaesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05884229 naunknown statusnot on this mapstarted 2023, after this paper: background citation

The Effect of SPI (Surgical Pleth Index) - Guided Anaesthesia Versus Conventional Analgesia on Opioid Consumption Under Multimodal Analgesia in Gastric Sleeve Surgery

TypeinterventionalSponsorIuliu Hatieganu University of Medicine and PharmacyRan2023 to 2024Enrolled40ConditionsIntraoperative MonitoringArmsIntra-operative analgesia guided by SPI
NCT07703384 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Comparison of The Perfusion Index and The Surgical Pleth Index in Detecting The Effectiveness of Caudal Block in Pediatric Patients Undergoing Infraumbilical Surgeries Under General Anesthesia: A Prospective Observational Study

TypeobservationalSponsorFayoum University HospitalRan2026 to 2027Enrolled40ConditionsThe Success of Caudal BlockArmscaudal block
3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

T LedowskiUniversity of Western Australia, Perth, Australia; Royal Perth Hospital, Perth, Australia. Electronic address: Thomas.ledowski@health.wa.gov.au.
M SchneiderChristian-Albrechts-University Kiel, Kiel, Germany.
M GruenewaldChristian-Albrechts-University Kiel, Kiel, Germany.
R K GoyalRoyal Perth Hospital, Perth, Australia.
S R TeoRoyal Perth Hospital, Perth, Australia.
J HrubyArmadale Health Services, Perth, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReported outcome benefits after surgical pleth index (SPI, GE Healthcare, Helsinki, Finland) guided anaesthesia are conflicting. One potential explanation may be the lack of evidence for the selection of meaningful SPI target values. A recently published trial found an SPI cut-off of 30 as a 'best-fit' to predict moderate-to-severe acute postoperative pain. This prospective trial was designed to validate this target and to investigate the influence of patient age on SPI in this context.

methodsAfter ethics approval, 200 patients undergoing non-emergency surgery were enrolled. Data related to SPI, heart rate (HR), and mean arterial pressure (MAP) were recorded for the last 5 min of surgery, just before arousal. After admission to recovery, pain scores (numeric rating scale [NRS], 0-10) were obtained every 5 min for 15 min.

resultsThe data of 196 patients were analysed. Receiver-operating curve analysis showed a cut-off SPI value of 29 to be the optimum intraoperative target to discriminate between NRS 0-3 and 4-10. This confirms the 'best fit' cut-off for SPI published previously. Though still superior to HR and MAP, the sensitivity and specificity of the SPI were only poor. Age had no influence on the predictive accuracy of SPI.

conclusionsAn SPI of approximately 30 was confirmed as having the best sensitivity/specificity to predict moderate-to-severe pain in the postanaesthesia care unit. However, the predictive accuracy was overall poor and not influenced by patient age. CLINICAL

trial registrationACTRN12617001475336.

Indexed as

AdolescentAdultAgedAged, 80 and overAge FactorsFemaleHeart RateHumansMaleMiddle AgedMonitoring, IntraoperativePlethysmographyPostoperative PainProspective StudiesReproducibility of ResultsSensitivity and Specificityagemonitorpain assessmentpostoperative painsurgical pleth index

Identifiers

PMID30916030
PMCPMC6676013

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.