Effect of propofol and remifentanil on a somatosensory evoked potential indicator of pain perception intensity in volunteers

Verfasser / Beitragende:
[Ana Castro, Pedro Amorim, Catarina Nunes, Fernando de Almeida]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/5(2015-10-01), 561-567
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10877-014-9632-0  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10877-014-9632-0 
245 0 0 |a Effect of propofol and remifentanil on a somatosensory evoked potential indicator of pain perception intensity in volunteers  |h [Elektronische Daten]  |c [Ana Castro, Pedro Amorim, Catarina Nunes, Fernando de Almeida] 
520 3 |a Somatosensory evoked potentials (SEPs) have been linked to noxious activation and stimulus intensity. In this exploratory study we investigated the impact of anaesthetic drugs on SEPs and pain ratings, to assess their applicability as an objective measure of the nociception/anti-nociception balance. Following institutional approval and written informed consent, 10 healthy adult volunteers were enrolled (29.5±9.1years, 63.0±8.9kg and 171.4±7.2). Median nerve electrical stimulation was adjusted according to volunteers' sensitive, motor and painful thresholds (PT). Baseline SEPs were registered, and remifentanil and propofol administered using a stair scheme TCI. For each drug combination a 1.3×PT stimulus was administered, and volunteers evaluated pain intensity in a numerical rating scale (0-10). SEPs' amplitudes and latencies were normalized by the baseline values, reducing volunteers' intervariability. Stimulation currents varied between 6-52mA (1.3×PT) and pain ratings between 0 and 9. Cortical SEPs latencies were decreased for higher stimulus intensities (P<0.01), accompanied by increased pain ratings (P<0.01). An individually adjusted/normalized ratio based on cortical SEPs amplitude and interpeak latency is proposed( $$R_{Norm}$$ R N o r m ): $$R_{Norm}$$ R N o r m and NSR were significantly correlated in three out of nine subjects, and $$R_{Norm}$$ R N o r m and remifentanil Ce were significantly correlated in two (low number of evaluation points). $$R_{Norm}$$ R N o r m was shown to decrease with increasing doses of propofol and remifentanil (P<0.05). The proposed metric was depressed by anaesthetics and reflected pain evaluations. Further research is necessary to increase the number of volunteers and drugs' combination, to assess its applicability during surgically adequate anesthetic leves. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Pain  |2 nationallicence 
690 7 |a Nociception  |2 nationallicence 
690 7 |a Monitoring  |2 nationallicence 
690 7 |a Somatosensory evoked potentials (SEPs)  |2 nationallicence 
690 7 |a TIVA  |2 nationallicence 
700 1 |a Castro  |D Ana  |u Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, sn, 4200-465, Porto, Portugal  |4 aut 
700 1 |a Amorim  |D Pedro  |u Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Hospital de Santo António, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal  |4 aut 
700 1 |a Nunes  |D Catarina  |u Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Hospital de Santo António, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal  |4 aut 
700 1 |a de Almeida  |D Fernando  |u Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, sn, 4200-465, Porto, Portugal  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/5(2015-10-01), 561-567  |x 1387-1307  |q 29:5<561  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-014-9632-0  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-014-9632-0  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Castro  |D Ana  |u Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, sn, 4200-465, Porto, Portugal  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Amorim  |D Pedro  |u Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Hospital de Santo António, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nunes  |D Catarina  |u Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Hospital de Santo António, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a de Almeida  |D Fernando  |u Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, sn, 4200-465, Porto, Portugal  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/5(2015-10-01), 561-567  |x 1387-1307  |q 29:5<561  |1 2015  |2 29  |o 10877