J Clin Monit Comput - Monitoring nociception during general anesthesia with cardiorespiratory coherence.

Tópicos

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Resumo

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.

Resumo Limpo

novel wavelet transform cardiorespiratori coher wtcrc algorithm develop measur autonom state wtcrc may use nocicept index rang nocicept strong coher strong nocicept low coher aim studi estim sensit algorithm nocicept dental dam insert antinocicept bolus dose anesthet drug wtcrcs sensit compar mean heart rate hrmean mean noninvas blood pressur nibpmean common use clinic sign data collect children receiv general anesthesia dental surgeri time dental dam insert anesthet bolus event note realtim surgeri dental dam insert anesthet bolus event analyz chang averag wtcrc hrmean nibpmean calcul baselin period event respons period wilcoxon ranksum test use compar chang dental dam insert chang wtcrc nocicept index averag ci hrmean beatsmin nibpmean mmhg bolus dose anesthet chang wtcrc hrmean beatsmin nibpmean mmhg nocicept index base cardiorespiratori coher sensit nocicept antinocicept hrmean nibpmean wtcrc algorithm show promis noninvas monitor nocicept general anesthesia

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