Table_1_Performance of the Surgical Pleth Index and Analgesia Nociception Index in Healthy Volunteers and Parturients.docx

Various commercially available nociception devices have been developed to quantify intraoperative pain. The Surgical Pleth Index (SPI) and Analgesia Nociception Index (ANI) are among the analgesic indices that have been widely used for the evaluation of surgical patients. This study aimed to evaluate the clinical performance of the SPI and ANI in conscious healthy volunteers and parturients. Ten healthy volunteers and 10 parturients participated in this study. An algometer was used to induce bone pain in the volunteers until they rated their pain as five on the numerical rating scale (NRS); this procedure was repeated during the administration of remifentanil or normal saline. The study comprised two periods, and the volunteers were infused with different solutions in each period: normal saline during one period and remifentanil during the other in a randomized order. The parturients’ SPI and ANI data were collected for 2 min when they rated their pain levels as 0, 5, and 7 on the NRS, respectively. Both the SPI and ANI values differed significantly between NRS 0 and NRS 5 (P < 0.001) in the volunteers, irrespective of the solution administered (remifentanil or normal saline). At NRS 5, the SPI showed similar values, irrespective of remifentanil administration, while the ANI showed significantly lower values on remifentanil administration (P = 0.028). The SPI and ANI values at NRS 5 and NRS 7 did not differ significantly in the parturients (P = 0.101 for SPI, P = 0.687 for ANI). Thus, the SPI and ANI were effective indices for detecting pain in healthy volunteers and parturients.

目前已有多款商用伤害感受（nociception）监测设备问世，用于术中疼痛的量化评估。手术容积指数（Surgical Pleth Index, SPI）与镇痛伤害感受指数（Analgesia Nociception Index, ANI）是当前广泛应用于手术患者评估的镇痛指标之一。本研究旨在评估SPI与ANI在清醒健康志愿者及待产产妇中的临床应用性能。本研究共招募10名健康志愿者与10名待产产妇。研究人员使用痛觉计（algometer）对志愿者诱发骨痛，直至其数字疼痛评分量表（numerical rating scale, NRS）评分为5分；该操作会在输注瑞芬太尼（remifentanil）或生理盐水时重复进行。研究分为两个阶段，志愿者将以随机顺序在不同阶段输注不同溶液：一个阶段输注生理盐水，另一阶段输注瑞芬太尼。当待产产妇的NRS评分分别为0分、5分与7分时，研究人员将采集其2分钟的SPI与ANI数据。无论输注何种溶液（瑞芬太尼或生理盐水），志愿者在NRS 0分与NRS 5分时的SPI与ANI值均存在显著差异（P < 0.001）。在NRS 5分的状态下，SPI值不受瑞芬太尼输注的影响而保持相近水平，而ANI值在输注瑞芬太尼时则显著降低（P = 0.028）。待产产妇在NRS 5分与NRS 7分时的SPI与ANI值均无显著差异（SPI：P = 0.101；ANI：P = 0.687）。综上，SPI与ANI均可作为检测健康志愿者及待产产妇疼痛状态的有效指标。