학술논문

Influence of gravitational sympathetic stimulation on the surgical plethysmographic index
Document Type
Text
Source
Physiological research | 2015 Volume:64 | Number:2
Subject
Fyziologie člověka a srovnávací fyziologie
fyziologie
physiology
plethysmography
sympathetic activity
surgical pleth index
nociception
14
612
Language
English
Abstract
R. Colombo, A. Marchi, B. Borghi, T. Fossali, E. Tobaldini, S. Guzzetti, F. Raimondi.
Obsahuje bibliografii
Surgical Plethysmographic Index (SPI), calculated from pulse photo-plethysmographic amplitude oscillations, has been proposed as a tool to measure nociception anti-nociception balance during general anesthesia, but it is affected by several confounding factor that alter the autonomic nervous system (ANS) modulation. We hypothesized that SPI may be mainly affected by sympathetic stimulation independently from nociception. We studied the effects of two sympathetic stimuli on SPI, delivered through passive head-up tilt at 45 and 90 degrees angles, in nine awake healthy adults. The sympathetic modulation was assessed by means of heart rate variability (HRV) analysis. Mean (SD) SPI significantly increased from baseline to 45 degrees [from 38.6 (13.7) to 60.8 (7.6), p<0.001)] and to 90 degrees angle tilt [82.3 (5.4), p<0.001]. The electrocardiographic mean R-to-R interval significantly shortened during both passive tilts, whereas systolic arterial pressure did not change during the study protocol. HRV changed significantly during the study protocol towards a predominance of sympathetic modulation during passive tilt. Gravitational sympathetic stimulation at two increasing angles, in absence of any painful stimuli, affects SPI in awake healthy volunteers. SPI seems to reflect the sympathetic outflow directed to peripheral vessels.