Abstract:

Abstract: Objective To envaluate the accuracy of Photoplethysmograph pulse wave in monitoring stress reaction to
harmful stimulation. Methods Patients (n=75) were randomly assigned to three groups according to the dosages of fentanyl
that were administrated ( 4, 5 and 6 g/kg were given to F4, F5, F6 group respectively (n=25) in each group. Heart rate (HR),
Systemic blood pressure (SBP), Diastolic blood pressure (DBP), SpO2, the skin temperature of finger, perfusion index (PI), epi⁃
nephrine(E) and Norepinephrine (NE) were recorded at following time points: just in operation room (T1), 2 min after induc⁃
tion (T2), at intubation (T3),1 min (T4) and 5 min (T5) after intubation. And the PPGPW was printed and measured at the same
time points. Results PPGA and PI were significantly increased while E and NE were significantly decreased in T2 and T5,
compared with those baseline at T1 (P < 0.05). At T3, PPGA and PI were significantly decreased while NE markedly in⁃
creased in group F4 and F5 compared to T1. At T3, E in group F4 were remarkably increased h while E in group F5 were of no
obvious changed, compared with those at T1(P < 0.05). PPGA and PI increased while E and NE decreased in group F6 at T2,
T3 ,T4 and T5 compared with those at T1 (P < 0.05). In summary, PI was negatively correlated with plasma E and NE while PP⁃
GA was negatively correlated with plasma E and NE .Conclusion PPGA and PI are negatively associated with intensity of
stress response. And they can reflect the stress reaction during the induction period of intravenous anesthesia accurately.

Key words: anesthesia, general, fentanyl, intubation, intratracheal, photoplethysmography, nociceptive stress, perfu?
sion index, epinephrine, norepinephrine