Number of skin conductance fluctuations increase in a quantitative manner during tetanic pain stimuli whereas response entropy is non-reactive

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 31
Author(s):  
A. C. Gjerstad ◽  
H. Storm ◽  
R. Hagen ◽  
M. Huiku ◽  
E. Qvigstad ◽  
...  
Keyword(s):  
Skin Conductance ◽  
Conductance Fluctuations ◽  
Response Entropy ◽  
Quantitative Manner ◽  
Pain Stimuli

scholarly journals Ability of the Nociception Level, a Multiparameter Composite of Autonomic Signals, to Detect Noxious Stimuli during Propofol–Remifentanil Anesthesia

2015 ◽  
Vol 123 (3) ◽  
pp. 524-534 ◽  
Author(s):  
Chris H. Martini ◽  
Martijn Boon ◽  
Suzanne J. L. Broens ◽  
Evelien F. Hekkelman ◽  
Lisanne A. Oudhoff ◽  
...  
Keyword(s):  
Skin Conductance ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Skin Incision ◽  
Noxious Stimulation ◽  
Conductance Fluctuations ◽  
Nonlinear Composite ◽  
Dose Dependent Decrease ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Background: A novel multidimensional index of nociception, the nociception level (NoL) index, derived from the nonlinear composite of heart rate (HR), HR variability, amplitude of the photoplethysmogram, skin conductance, fluctuations in skin conductance, and their time derivatives, was used to assess nociception during anesthesia. Methods: Seventy-two American Society of Anesthesiologists I to III patients received propofol (target bispectral index, 45) and one of six remifentanil target concentrations in the range of 0 to 5 ng/ml. The NoL, mean arterial pressure (MAP; derived from a beat-to-beat finger cuff measurement), and HR were measured during nonnoxious, moderate noxious (skin incision), and intense noxious (intubation) stimulation. Values are represented as average (95% CI). Results: NoL, HR, and MAP did not change during nonnoxious events. Incision increased HR by 1.3/min (−0.46 to 3.1/min; not significant), MAP by 7.9 mmHg (−1.9 to 13.0 mmHg; not significant), and NoL by 8.0 (0.4 to 16.0; P < 0.001). Intubation increased HR by 7.0/min (1.4 to 12.0/min; P < 0.001), MAP by 13.0 mmHg (3.1 to 20 mmHg; P < 0.001), and NoL by 18.0 (7.8 to 29.0; P < 0.001). The ΔNoL area under the curve (0.95) of the receiver operating characteristic curve was greater compared with ΔHR (0.84, P < 0.001) and ΔMAP (0.78, P < 0.001). Under nonnociceptive conditions, remifentanil had no effect on NoL, in contrast to HR and MAP that showed a dose-dependent decrease. Conclusions: The NoL is a reliable measure of moderate and intense noxious stimulation and outperforms HR and MAP in differentiating noxious from nonnoxious stimuli. In contrast to HR and MAP, the NoL was not affected by hemodynamic effects of remifentanil.

scholarly journals Pain assessment in children undergoing venipuncture: the Wong–Baker faces scale versus skin conductance fluctuations

PeerJ ◽  
2013 ◽  
Vol 1 ◽  
pp. e37 ◽  
Author(s):  
Francesco Savino ◽  
Liliana Vagliano ◽  
Simone Ceratto ◽  
Fabio Viviani ◽  
Roberto Miniero ◽  
...  
Keyword(s):  
Skin Conductance ◽  
Pain Assessment ◽  
Conductance Fluctuations

Preliminary Intraoperative Validation of the Nociception Level Index

2016 ◽  
Vol 125 (1) ◽  
pp. 193-203 ◽  
Author(s):  
Ruth Edry ◽  
Vasile Recea ◽  
Yuri Dikust ◽  
Daniel I. Sessler
Keyword(s):  
Heart Rate ◽  
Skin Conductance ◽  
Plasma Concentrations ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Skin Incision ◽  
Noninvasive Blood Pressure ◽  
Trocar Insertion ◽  
Conductance Fluctuations ◽  
Opioid Administration

Abstract Background The nociception level (NoL) index is an index of nociception based on nonlinear combination of heart rate, heart rate variability, photoplethysmograph wave amplitude, skin conductance, skin conductance fluctuations, and their time derivatives. The authors evaluated the abilities of the NoL index and other measures of nociception to discriminate between noxious and nonnoxious stimuli, to progressively respond to graded stimuli, and to respond to opioid administration. Methods Intraoperative NoL was compared to heart rate, pulse plethysmograph amplitude, noninvasive blood pressure, and the surgical pleth index around five specific stimuli: tetanic stimulation with and without fentanyl analgesia, intubation, first incision/trocar insertion, and a nonnoxious period. The response around first incision was analyzed at two target plasma concentrations of remifentanil. Results In 58 patients, the NoL index responded progressively to increased stimulus intensity and remained unchanged in response to nonnoxious stimuli. Compared to other accepted measures of nociception, the NoL index better discriminated noxious from nonnoxious stimuli with an area under the curve of 0.93 (95% CI, 0.89 to 0.97) and a sensitivity of 87% at a specificity of 84%. The NoL index was the only measure that reliably reflected two different analgesic concentrations of remifentanil during initial skin incision or trocar insertion. Conclusions The NoL index changes proportionately with patients’ response to various clinical and experimental noxious stimuli and discriminates noxious from nonnoxious stimuli with high sensitivity and specificity. The NoL index also responds progressively to increasing stimuli intensity and is appropriately blunted by analgesic administration. The NoL index was superior to other compared measures and appears to accurately characterize nociception during general anesthesia.

Increase in skin conductance variables versus increase in State entropy and Response entropy during emergence after surgery in general anaesthesia

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 30-31
Author(s):  
A. C. Gjerstad ◽  
H. Storm ◽  
R. Hagen ◽  
M. Huiku ◽  
E. Qvigstad ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Skin Conductance ◽  
State Entropy ◽  
Response Entropy

Pain Influences Several Levels of Attention

2005 ◽  
Vol 16 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Astrid von Bueren Jarchow ◽  
Bogdan P. Radanov ◽  
Lutz Jäncke
Keyword(s):  
Chronic Pain ◽  
Divided Attention ◽  
Covert Attention ◽  
Attention Task ◽  
Attentional Deficits ◽  
Control Subjects ◽  
Chronic Pain Patients ◽  
Divided Attention Task ◽  
Pain Stimuli ◽  
Pain Patients

Abstract: The aim of the present study was to examine to what extent chronic pain has an impact on various attentional processes. To measure these attention processes a set of experimental standard tests of the “Testbatterie zur Aufmerksamkeitsprüfung” (TAP), a neuropsychological battery testing different levels of attention, were used: alertness, divided attention, covert attention, vigilance, visual search, and Go-NoGo tasks. 24 chronic outpatients and 24 well-matched healthy control subjects were tested. The control subjects were matched for age, gender, and education. The group of chronic pain patients exhibited marked deficiencies in all attentional functions except for the divided attention task. Thus, the data supports the notion that chronic pain negatively influences attention because pain patients` attention is strongly captivated by the internal pain stimuli. Only the more demanding divided attention task has the capability to distract the focus of attention to the pain stimuli. Therefore, the pain patients are capable of performing within normal limits. Based on these findings chronic pain patients' attentional deficits should be appropriately evaluated and considered for insurance and work related matters. The effect of a successful distraction away from the pain in the divided attention task can also open new therapeutic aspects.

Sign in / Sign up

Export Citation Format

Share Document