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Anesthesiology Research and Practice
Volume 2010, Article ID 810721, 5 pages
Clinical Study

Performance of Surgical Stress Index during Sevoflurane-Fentanyl and Isoflurane-Fentanyl Anesthesia

1Department of Anesthesia, South Carelia Central Hospital, Valtokäkelänkatu 1, 53130 Lappeenranta, Finland
2Clinical Research, GE Healthcare Finland Oy, P.O. Box 900, 00031 GE Helsinki, Finland

Received 26 October 2009; Accepted 8 February 2010

Academic Editor: James B. Eisenkraft

Copyright © 2010 S. Mustola et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The performance of recently introduced Surgical Stress Index (SSI), based on heart rate and photoplethysmography, was estimated during sevoflurane-fentanyl and isoflurane-fentanyl anesthesia during surgical procedures. Forty ASA I–III patients were enrolled. Anesthesia was induced with fentanyl 2  and thiopentone 3–5 mg  . Tracheal intubation was performed 5 minutes after fentanyl bolus. Patients were randomly allocated to receive sevoflurane ( ) or isoflurane ( ) in 30% oxygen/air. State entropy was kept at 40–60, target being 50. During surgery, fentanyl boluses 1.5  were given at 30–40-minute intervals. SSI increased significantly after intubation. During surgery, the decrease of SSI after fentanyl boluses was similar in sevoflurane and isoflurane groups but SSI values were higher in sevoflurane than in isoflurane group. Tracheal intubation, skin incision, and surgical stimuli increased SSI from baseline, indicating that nociceptive stimuli increase SSI. Fentanyl boluses during surgery decreased SSI, indicating that increasing analgesia decreases SSI.