Monitoring nociception during general anesthesia with cardiorespiratory coherence.
A novel wavelet transform cardiorespiratory coherence (WTCRC) algorithm has been developed to measure the autonomic state. WTCRC may be used as a nociception index, ranging from 0 (no nociception, strong coherence) to 100 (strong nociception, low coherence). The aim of this study is to estimate the...
| Published in: | Journal of Clinical Monitoring & Computing Vol. 27; no. 5; pp. 551 - 561 |
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| Main Authors: | , , , , , , , |
| Format: | clinical trial research Journal Article |
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Springer Nature
Oct2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104096171&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104096171 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Oct2013 vid: 27 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104096171 NLM23568315 2012297383 10.1007/s10877-013-9463-4 NLM23568315 104096171 ppf: 551 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Monitoring nociception during general anesthesia with cardiorespiratory coherence. aug: au: Brouse, Chris J Karlen, Walter Dumont, Guy A Myers, Dorothy Cooke, Erin Stinson, Jonathan Lim, Joanne Ansermino, J Mark affil: Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada, chris.brouse@gmail.com. sug: subj: Anesthesia, General Methods Heart Rate Intraoperative Monitoring Methods Pain Measurement Methods Postoperative Pain Diagnosis Respiratory Rate Surgery, Oral Methods Anesthetics, General Administration and Dosage Child Child, Preschool Clinical Trials Diagnosis, Computer Assisted Methods Female Human Male Postoperative Pain Etiology Propofol Administration and Dosage Reproducibility of Results Sensitivity and Specificity Signal Processing, Computer Assisted Surgery, Oral Adverse Effects Child: 6-12 years Child, Preschool: 2-5 years Female Male ab: A novel wavelet transform cardiorespiratory coherence (WTCRC) algorithm has been developed to measure the autonomic state. WTCRC may be used as a nociception index, ranging from 0 (no nociception, strong coherence) to 100 (strong nociception, low coherence). The aim of this study is to estimate the sensitivity of the algorithm to nociception (dental dam insertions) and antinociception (bolus doses of anesthetic drugs). WTCRC's sensitivity is compared to mean heart rate (HRmean) and mean non-invasive blood pressure (NIBPmean), which are commonly used clinical signs. Data were collected from 48 children receiving general anesthesia during dental surgery. The times of dental dam insertion and anesthetic bolus events were noted in real-time during surgeries. 42 dental dam insertion and 57 anesthetic bolus events were analyzed. The change in average WTCRC, HRmean, and NIBPmean was calculated between a baseline period before each event and a response period after. A Wilcoxon rank-sum test was used to compare changes. Dental dam insertion changed the WTCRC nociception index by an average of 14 (82 %) [95 % CI from 7.4 to 19], HRmean by 7.3 beats/min (8.1 %) [5.6-9.6], and NIBPmean by 8.3 mmHg (12 %) [4.9-13]. A bolus dose of anesthetics changed the WTCRC by -15 (-50 %) [-21 to -9.3], HRmean by -4.8 beats/min (4.6 %) [-6.6 to -2.9], and NIBPmean by -2.6 mmHg (3.4 %) [-4.7 to -0.50]. A nociception index based on cardiorespiratory coherence is more sensitive to nociception and antinociception than are HRmean or NIBPmean. The WTCRC algorithm shows promise for noninvasively monitoring nociception during general anesthesia. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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