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Nociception monitoring

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https://www.readbyqxmd.com/read/28432612/evaluation-of-the-analgesia-nociception-index-ani-in-healthy-awake-volunteers
#1
Rami Issa, Marco Julien, Elizabeth Décary, Olivier Verdonck, Louis-Philippe Fortier, Pierre Drolet, Philippe Richebé
BACKGROUND: Analgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28410821/-analgesia-nociception-index-for-perioperative-analgesia-monitoring-in-spinal-surgery
#2
Guldem Turan, Arzu Yıldırım Ar, Yıldız Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, Erhan Celikoglu
BACKGROUND AND OBJECTIVES: The Analgesia Nociception Index is an index used to measure the levels of pain, sympathetic system activity and heart rate variability during general anesthesia. In our study, Analgesia Nociception Index monitoring in two groups who had undergone spinal stabilization surgery and were administered propofol-remifentanil (Total Intravenous Anesthesia) and sevoflurane-remifentanyl anesthesia was compared regarding its significance for prediction of postoperative early pain...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28360106/ca-2-and-calpain-mediate-capsaicin-induced-ablation-of-axonal-terminals-expressing-transient-receptor-potential-vanilloid-1
#3
Sheng Wang, Sen Wang, Jamila Asgar, John Joseph, Jin Y Ro, Feng Wei, James N Campbell, Man-Kyo Chung
Capsaicin is an ingredient in spicy peppers that produces burning pain by activating transient receptor potential vanilloid 1 (TRPV1), a Ca2+-permeable ion channel in nociceptors. Capsaicin also has been used as an analgesic, and its topical administration is approved for the treatment of certain pain conditions. The mechanisms underlying capsaicin-induced analgesia likely involve reversible ablation of nociceptor terminals. However, the mechanisms underlying these effects are not well understood. To visualize TRPV1-lineage axons, a genetically engineered mouse model was used in which a fluorophore is expressed under TRPV1 promoter...
March 30, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28341079/monitoring-of-nociception-reality-or-fiction
#4
A Abad-Gurumeta, J Ripollés-Melchor, R Casans-Francés, J M Calvo-Vecino
There are currently various projects underway that attempt to monitor the nociceptive responses caused by surgical stress and ensure patients the best analgesic conditions. The systemic response to surgical stress has repercussions in the postoperative period, such as worse pain control, delayed recovery, greater complications, longer stay in resuscitation and hospital units, and increased healthcare costs. However, treatment with higher doses of opioids than necessary may lead to slower awakening, increased drowsiness and adverse effects, as well as situations of postoperative opioid-induced hyperalgesia...
March 21, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28268478/comparison-of-pulse-rate-variability-and-heart-rate-variability-for-high-frequency-content-estimation
#5
R Logier, J De Jonckheere, A Dassonneville, M Jeanne
Heart Rate Variability (HRV) analysis can be of precious help in most of clinical situations because it is able to quantify the Autonomic Nervous System (ANS) activity. The HRV high frequency (HF) content, related to the parasympathetic tone, reflects the ANS response to an external stimulus responsible of pain, stress or various emotions. We have previously developed the Analgesia Nociception Index (ANI), based on HRV high frequency content estimation, which quantifies continuously the vagal tone in order to guide analgesic drug administration during general anesthesia...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226651/comparison-of-pulse-rate-variability-and-heart-rate-variability-for-high-frequency-content-estimation
#6
R Logier, J De Jonckheere, A Dassonneville, M Jeanne, R Logier, J De Jonckheere, A Dassonneville, M Jeanne, A Dassonneville, J De Jonckheere, R Logier, M Jeanne
Heart Rate Variability (HRV) analysis can be of precious help in most of clinical situations because it is able to quantify the Autonomic Nervous System (ANS) activity. The HRV high frequency (HF) content, related to the parasympathetic tone, reflects the ANS response to an external stimulus responsible of pain, stress or various emotions. We have previously developed the Analgesia Nociception Index (ANI), based on HRV high frequency content estimation, which quantifies continuously the vagal tone in order to guide analgesic drug administration during general anesthesia...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28141703/intraoperative-monitoring-of-analgesia-using-nociceptive-reflexes-correlates-with-delayed-extubation-and-immediate-postoperative-pain-a-prospective-observational-study
#7
Axel Jakuscheit, Johannes Weth, Gregor Lichtner, Carlo Jurth, Benno Rehberg, Falk von Dincklage
BACKGROUND: Immediate postoperative pain could be prevented by the administration of long-lasting analgesics before the end of the anaesthesia. However, to prevent over or underdosing of analgesics under anaesthesia, tools are required to estimate the analgesia-nociception balance. OBJECTIVE: We investigated whether the pupillary dilation reflex (PDR) and the nociceptive flexion reflex (NFR) at the end of general anaesthesia correlate with immediate postoperative pain, as a sign of analgesic underdosing, and with delayed tracheal extubation as a sign of analgesic overdosing...
May 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28107273/influence-of-depth-of-hypnosis-on-pupillary-reactivity-to-a-standardized-tetanic-stimulus-in-patients-under-propofol-remifentanil-target-controlled-infusion-a-crossover-randomized-pilot-study
#8
Nada Sabourdin, Jean-Baptiste Peretout, Eliane Khalil, Marie-Laurence Guye, Nicolas Louvet, Isabelle Constant
BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related to the amount of administered opioids. The objective of this study was to determine whether at a constant infusion rate of opioids, the pupillary response was influenced by depth of hypnosis assessed by the bispectral index (BIS)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28066825/a-blinded-randomised-placebo-controlled-trial-investigating-the-efficacy-of-morphine-analgesia-for-procedural-pain-in-infants-trial-protocol
#9
Rebeccah Slater, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E Norman, Chetan Patel, Kayleigh Stanbury, Amy Hoskin, Gabrielle Green
Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia...
November 15, 2016: Wellcome Open Research
https://www.readbyqxmd.com/read/28057535/the-nitric-oxide-donor-isosorbide-dinitrate-induces-a-cephalic-cutaneous-hypersensitivity-associated-with-sensitization-of-the-medullary-dorsal-horn
#10
José María Flores Ramos, Laurent Devoize, Amélie Descheemaeker, Jean-Louis Molat, Philippe Luccarini, Radhouane Dallel
Nitric oxide donors are known to produce headache in healthy as well as migraine subjects, and to induce extracephalic cutaneous hypersensitivity in rodents. However, little is known on the effect of nitric oxide donors on cephalic cutaneous sensitivity. Combining behavioral, immunohistochemical, and in vivo electrophysiological approaches, this study investigated the effect of systemic administration of the nitric oxide donor, isosorbide dinitrate (ISDN), on cephalic and extracephalic cutaneous sensitivity and on neuronal activation within the medullary dorsal horn (MDH) in the rat...
March 6, 2017: Neuroscience
https://www.readbyqxmd.com/read/28044336/monitoring-regional-blockade
#11
REVIEW
K Ode, S Selvaraj, A F Smith
This review attempts to draw on the published literature to address three practical clinical questions. First, what means of testing the degree of regional blockade pre-operatively are available, and can eventual success or failure be determined soon after injection? Second, is it possible to predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes? Third, what features, and what duration, should cause concern when a block does not resolve as expected after surgery? Although the relevant literature is limited, we recommend testing of multiple sensory modalities before surgery commences; temperature and thermographic changes may offer additional early warning of success or failure...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28006939/the-effect-of-combined-treatment-of-opioids-with-methylphenidate-on-nociception-in-rats-and-pain-in-human
#12
A Yamamotová, J Fricová, R Rokyta, R Šlamberová
Methylphenidate hydrochloride (MPH/Ritalin) is a stimulant used for off-label management of cancer-related fatigue and sedation; however, its use in pain treatment is still relatively rare. This study 1) compares the antinociceptive effect of MPH and its combination with morphine (MOR) in adult male Wistar rats after a single administration of MPH, MOR or their combination, and 2) compares the analgesic effects of opioids and Ritalin combined therapy with opioid monotherapy in patients with cancer pain. To objectively assess physical activity during a three-week monitoring period, patients were equipped with Actiwatch Score Actigraph...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27875927/what-is-being-trained-how-divergent-forms-of-plasticity-compete-to-shape-locomotor-recovery-after-spinal-cord-injury
#13
J Russell Huie, Kazuhito Morioka, Jenny Haefeli, Adam R Ferguson
Spinal cord injury (SCI) is a devastating syndrome that produces dysfunction in motor and sensory systems, manifesting as chronic paralysis, sensory changes, and pain disorders. The multi-faceted and heterogeneous nature of SCI has made effective rehabilitative strategies challenging. Work over the last 40 years has aimed to overcome these obstacles by harnessing the intrinsic plasticity of the spinal cord to improve functional locomotor recovery. Intensive training after SCI facilitates lower extremity function and has shown promise as a tool for retraining the spinal cord by engaging innate locomotor circuitry in the lumbar cord...
January 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27807964/analgesia-nociception-monitoring-for-opioid-guidance-meta-analysis-of-randomized-clinical-trials
#14
Matthias Gruenewald, Astrid Dempfle
INTRODUCTION: The adequate suppression of nociception is, besides induction of unconsciousness and immobility, the main objective during anesthesia. Analgesics, most commonly opioids, are usually titrated by established clinical surrogates of nociception. Recently, monitoring techniques became available to evaluate analgesia/nociception during anesthesia and provide better measures then clinical evaluation alone. They are primarily derived from autonomic response on physiologic standard measures...
February 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27766525/comparison-of-the-qcon-and-qnox-indices-for-the-assessment-of-unconsciousness-level-and-noxious-stimulation-response-during-surgery
#15
Umberto Melia, Eva Gabarron, Mercé Agustí, Nuria Souto, Patricia Pineda, Joan Fontanet, Montserrat Vallverdu, Erik Weber Jensen, Pedro Gambus
The objective of this work is to compare the performances of two electroencephalogram based indices for detecting loss of consciousness and loss of response to nociceptive stimulation. Specifically, their behaviour after drug induction and during recovery of consciousness was pointed out. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. The qCON 2000 monitor (Quantium Medical, Barcelona, Spain) was used to calculate the qCON and qNOX. Loss of response to verbal command and loss of eye-lash reflex were assessed during the transition from awake to anesthetized, defining the state of loss of consciousness...
October 20, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27749829/trpa1-mediates-sensation-of-the-rate-of-temperature-change-in-drosophila-larvae
#16
Junjie Luo, Wei L Shen, Craig Montell
Avoidance of noxious ambient heat is crucial for survival. A well-known phenomenon is that animals are sensitive to the rate of temperature change. However, the cellular and molecular underpinnings through which animals sense and respond much more vigorously to fast temperature changes are unknown. Using Drosophila larvae, we found that nociceptive rolling behavior was triggered at lower temperatures and at higher frequencies when the temperature increased rapidly. We identified neurons in the brain that were sensitive to the speed of the temperature increase rather than just to the absolute temperature...
January 2017: Nature Neuroscience
https://www.readbyqxmd.com/read/27742411/inhibition-of-reinforcing-hyperalgesic-and-motor-effects-of-morphine-by-buspirone-in-rats
#17
Darakhshan Jabeen Haleem, Shazia Nawaz
Morphine and other opioids are among the most effective prescription medications for the treatment of pain. Addiction and hyperalgesia associated with their long-term use limits the clinical utility of these drugs. In view of a role of somatodendritic serotonin-1A receptors in addiction and analgesic effects of morphine, the present study concerns effects of co-use of buspirone, a partial agonist at the serotonin-1A receptor, on reinforcing, hyperalgesic, and motor effects of morphine in rats. A dose of morphine (7...
January 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27703336/profile-of-the-capsaicin-8-patch-for-the-management-of-neuropathic-pain-associated-with-postherpetic-neuralgia-safety-efficacy-and-patient-acceptability
#18
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27702648/probing-pain-pathways-with-light
#19
Feng Wang, Erik Bélanger, Marie-Eve Paquet, Daniel Côté, Yves De Koninck
We have witnessed an accelerated growth of photonics technologies in recent years to enable not only monitoring the activity of specific neurons, while animals are performing certain types of behavior, but also testing whether specific cells, circuits, and regions are sufficient or necessary for initiating, maintaining, or altering this or that behavior. Compared to other sensory systems, however, such as the visual or olfactory system, photonics applications in pain research are only beginning to emerge. One reason pain studies have lagged behind is that many of the techniques originally developed cannot be directly implemented to study key relay sites within pain pathways, such as the skin, dorsal root ganglia, spinal cord, and brainstem...
October 1, 2016: Neuroscience
https://www.readbyqxmd.com/read/27693901/efficacy-and-safety-of-two-methadone-titration-methods-for-the-treatment-of-cancer-related-pain-the-equimeth2-trial-methadone-for-cancer-related-pain
#20
Philippe Poulain, Marie-Pierre Berleur, Shimsi Lefki, Danièle Lefebvre, Gisèle Chvetzoff, Eric Serra, Fibra Tremellat, Alain Derniaux, Marilène Filbet
CONTEXT: In the European Association for Palliative Care recommendations for cancer pain management, there was no consensus regarding the indications, titration, or monitoring of methadone. OBJECTIVES: This national, randomized, multicenter trial aimed to compare two methadone titration methods (stop-and-go vs. progressive) in patients with cancer-related pain who were inadequately relieved by or intolerant to Level 3 opioids. METHODS: The primary end point was the rate of success/failure at Day 4, defined as pain relief (reduction of at least two points on the visual scale and a pain score <5 for two consecutive days) and no overdose (Rudkin scale ≥3 and respiratory rate <8/minute)...
November 2016: Journal of Pain and Symptom Management
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