Do we feel pain during anesthesia? A critical review on surgery-evoked circulatory changes and pain perception. Issue 4 (December 2017)

• Record Type: Journal Article
• Authors: Cividjian, A.; Petitjeans, F.; Liu, N.; Ghignone, M.; de Kock, M.; Quintin, L.
• Is Part Of: Best practice & research. Volume 31:Issue 4(2017)
• Page Start: 445
• Page End: 467
• Publication Date: 2017-12
• Subjects: surgery -- anesthesia -- movement -- analgesia -- pain -- nociception -- anti-nociception -- vasomotor center -- RVLM -- nucleus ambiguus -- cardiac vagal motoneurons -- presympathetic neurons -- somato-sympathetic reflex -- cardiac baroreflex -- vasomotor baroreflex -- SPI -- SSI -- ANI -- CARDEAN -- analgesics -- opioid -- nonopioid analgesics -- hyperalgesia -- alpha-2 agonist -- respiratory genesis -- ventilatory depression -- opioid-free anesthesia -- OFA; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1016/j.bpa.2017.05.001
• Languages: English
• ISSNs: 1521-6869

Abstract

Abstract : The difficulty of defining the three so-called components of « an-esthesia » is emphasized: hypnosis, absence of movement, and adequacy of anti-nociception (intraoperative « analgesia »). Data obtained from anesthetized animals or humans delineate the activation of cardiac and vasomotor sympathetic reflex (somato-sympathetic reflex) and the cardiac parasympathetic deactivation observed following somatic stimuli. Sympathetic activation and parasympathetic deactivation are used as monitors to address the adequacy of intraoperative anti-nociception. Finally, intraoperative nociception through the administration of nonopioid analgesics vs. opioid analgesics is considered to achieve minimal postoperative side effects.