Changes in the Nociception Level Index During Surgical Resection of Paragangliomas: A Case Report. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Saynhalath, Rita; Khan, Umar H.; Alex, Gijo; Murphy, Joseph T.; Szmuk, Peter
• Is Part Of: A & A practice. Volume 15:Issue 11(2020)
• Publication Date: 2021-11
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000001542
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : Nociception is the detection of noxious stimulation by the nervous system. The PMD-200 monitor is a validated, emerging technology for intraoperative monitoring using the nociception level (NOL) index. We describe a pediatric case of an open resection of paraganglionic masses during which episodic increases in NOL index and blood pressure coincided with tumor manipulation, presumably due to a catecholamine surge. Since the patient was under stable and adequate analgesia, the increases in NOL index likely reflected the physiologic effects of tumor handling rather that the presence of a true noxious stimulus. Clinicians should consider this limitation when using this monitor.