关键词: ANI CARDEAN OFA RVLM SPI SSI alpha-2 agonist analgesia analgesics anesthesia anti-nociception cardiac baroreflex cardiac vagal motoneurons hyperalgesia movement nociception nonopioid analgesics nucleus ambiguus opioid opioid-free anesthesia pain presympathetic neurons respiratory genesis somato-sympathetic reflex surgery vasomotor baroreflex vasomotor center ventilatory depression

Mesh : Analgesics / administration & dosage Anesthesia / methods Animals Humans Intraoperative Neurophysiological Monitoring / methods Neural Pathways / drug effects physiology Pain Measurement / drug effects methods Pain Perception / drug effects physiology Regional Blood Flow / drug effects physiology

来  源:   DOI:10.1016/j.bpa.2017.05.001   PDF(Sci-hub)

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.
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