Novel multiparameter approach for measurement of nociception at skin incision during general anaesthesia†‡ M Rantanen, A Yli-Hankala, M van Gils, H Yppa¨rila¨-Wolters,

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Novel multiparameter approach for measurement of nociception at skin incision during general anaesthesia†‡ M Rantanen, A Yli-Hankala, M van Gils, H Yppa¨rila¨-Wolters, P Takala, M Huiku, M Kyma¨la¨inen, E Seitsonen, I Korhonen British Journal of Anaesthesia Volume 96, Issue 3, Pages 367-376 (March 2006) DOI: 10.1093/bja/ael005 Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 1 Distribution of CSSA values for patients in the development of RN group (n=55). British Journal of Anaesthesia 2006 96, 367-376DOI: (10.1093/bja/ael005) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 2 RN plotted as a function of CSSA score. Circles represent the average post-incision RN values after start of skin incision in the 55 patients, whose parameters were used in the development of RN. Values of an additional 10 patients, not used in development of RN, are marked with crosses. British Journal of Anaesthesia 2006 96, 367-376DOI: (10.1093/bja/ael005) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 3 Behaviour of RN differentiates patients with big incision from the others (a) (P=0.04); movers from non-movers (b) (P=0.02); and low, intermediate, or high effect site concentrations of remifentanil from each other (c) (P=0.00031). Values on the horizontal axis indicate time relative to the moment of skin incision. The curves show the mean RN. The length of the error bars indicates se. Curves are calculated over all cases (n=55) for (b) and for non-movers only (n=50) for (a) and (c). British Journal of Anaesthesia 2006 96, 367-376DOI: (10.1093/bja/ael005) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions

Fig 4 Schematic presentation of the algorithm to calculate RN. All three modules use a multivariate equation. The outputs of these three equations are combined linearly to obtain the RN value. PPGV=pulse plethysmography variability. British Journal of Anaesthesia 2006 96, 367-376DOI: (10.1093/bja/ael005) Copyright © 2006 British Journal of Anaesthesia Terms and Conditions