Monitoring analgesia

Analgesia (pain relief) amnesia (loss of memory) and immobilisation are the three major components of anaesthesia. The perception of pain, and therefore, the need for analgesia, is individual, and the monitoring of analgesia is indirect and, in essence, of the moment. Under general anaesthesia, anal...

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Bibliographic Details
Published in:Best practice & research. Clinical anaesthesiology 2006-03, Vol.20 (1), p.161-180
Main Author: Guignard, Bruno
Format: Article
Language:English
Subjects:
anaesthesia
Analgesia
Analgesia - methods
Analysis
Anesthesia, General - methods
bispectral index
Consciousness - drug effects
Consciousness - physiology
Electroencephalography
Electroencephalography - methods
entropy
evoked potentials
Evoked Potentials - drug effects
Evoked Potentials - physiology
Heart Rate - drug effects
Heart Rate - physiology
heart rate variability
Humans
intraoperative
Laser-Doppler Flowmetry - methods
Monitoring, Intraoperative - methods
plethysmography
Plethysmography - methods
pupillary reflex
Reflex, Pupillary - drug effects
Reflex, Pupillary - physiology
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Summary:Analgesia (pain relief) amnesia (loss of memory) and immobilisation are the three major components of anaesthesia. The perception of pain, and therefore, the need for analgesia, is individual, and the monitoring of analgesia is indirect and, in essence, of the moment. Under general anaesthesia, analgesia is continually influenced by external stimuli and the administration of analgesic drugs, and cannot be really separated from anaesthesia: the interaction between analgesia and anaesthesia is inescapable. Autonomic reactions, such as tachycardia, hypertension, sweating and lacrimation, although non-specific, are always regarded as signs of nociception or inadequate analgesia. Autonomic monitoring techniques, such as the analysis of heart rate variability, laser Doppler flowmetry, phlethysmographically derived indices and the pupillary light reflex, may help to quantitate reactions of the autonomic nervous system. For the past few years, automated electroencephalographic analysis has been of great interest in monitoring anaesthesia and could be useful in adapting the peroperative administration of opioids. A range of information collected from the electroencephalogram, haemodynamic readings and pulse plethysmography might be necessary for monitoring the level of nociception during anaesthesia. Information theory, multimodal monitoring, and signal processing and integration are the basis of future monitoring.
ISSN:1521-6896
1532-169X
DOI:10.1016/j.bpa.2005.09.002