European Journal of Molecular & Clinical Medicine

Abstract

Background: The stress response to surgery is an unconscious response to tissue injury and
refers to autonomic, hormonal and metabolic changes that follow injury or trauma. Excessive
intraoperative stress evoked by surgical nociceptive stimulation may influence patient’s
outcome, length of hospital stay and overall costs of hospital care. Traditionally, clinical signs
like somatic or autonomic responses are used to evaluate whether analgesia is adequate. It has
been proved to be unreliable demonstrating low specificity. In the present study
hemodynamic changes are correlated with changes in surgical plethysmographic index (SPI)
and entropy at the time of stress.
Methods: A prospective non-randomised observational study was conducted in the patients
posted for elective laparoscopic cholecystectomy. Hundred ASA physical status I and II
patients aged between 18 to 60 years belonging to both the gender scheduled for elective
laparoscopic cholecystectomy were enrolled in the study.
Results: According to the correlation coefficient values SPI values are correlating with
changes in heart rate, systolic blood pressure and diastolic blood pressure at the time points of
5 min after intubation, 10 mins after intubation and before inflation. Entropy values does not
correlate with SPI as entropy indicates hypnosis level where as SPI is based on sympathetic
and parasympathetic stimulation. State entropy correlates with changes in systolic and
diastolic blood pressure at the time points of before inflation, 30 min after inflation and
deflation. However state and response entropy correlates with each
Other. Response entropy correlates with changes in systolic and diastolic blood pressure at
the time points of 5 mins after intubation and before inflation.