Document Detail

Surgical stress index in response to pacemaker stimulation or atropine.
MedLine Citation:
PMID:  20573632     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The surgical stress index (SSI) is a new monitoring tool for the assessment of nociception during general anaesthesia. It is calculated based on the heart beat interval and the pulse wave amplitude. Correlation of SSI with nociceptive stimuli and opioid effect-site concentrations has been demonstrated, but the influence of isolated modulation of heart rate (HR) on SSI is still unclear. The aim of this study was to evaluate the effect on SSI of atropine administration and cardiac pacing. METHODS: In 18 anaesthetized ASA III ICU patients, either repetitive cardiac pacemaker stimulation or administration of atropine (10 microg kg(-1)) was performed, and the effect on SSI, arterial pressure, spectral entropy, and bispectral index was analysed. RESULTS: Cardiac pacing at 100 beats min(-1) was followed by an increase in SSI from 26 [17-35 (10-41)] to 59 [53-72 (48-78)] {median [inter-quartile range (range)]} (P=0.0006), whereas other variables remained unaffected. Also, atropine administration increased SSI from 27 [20-34 (16-39)] to 58 [48-70 (41-81)] (P=0.007) without significant effect on other variables except HR. A recalibration of SSI during cardiac pacing leads to a significant decrease in SSI to 49 [40-52 (36-57)] (P=0.03), whereas recalibration after atropine administration had no effect. CONCLUSIONS: SSI values measured in patients receiving atropine or in patients with pacemakers should be interpreted cautiously.
J Höcker; O Broch; J Th Gräsner; M Gruenewald; C Ilies; M Steinfath; B Bein
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-23
Journal Detail:
Title:  British journal of anaesthesia     Volume:  105     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  150-4     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, Kiel, Germany.
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MeSH Terms
Aged, 80 and over
Anti-Arrhythmia Agents / pharmacology*
Atropine / pharmacology*
Blood Pressure / drug effects
Coronary Artery Bypass
Electroencephalography / drug effects
Heart Rate / drug effects
Intensive Care / methods
Monitoring, Physiologic / methods
Pacemaker, Artificial*
Postoperative Care / methods
Stress, Physiological / drug effects*
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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