Abstract:
The association between intraoperative nociception and increased patient\'s morbidity is well established. However, hemodynamic parameters, such as heart rate and blood pressure, may result in an inadequate monitor of nociception during surgery. Over the last two decades, different devices have been marketed to \"reliably\" detect intraoperative nociception. Since the direct measure of nociception is impractical during surgery, these monitors measures nociception surrogates such as sympathetic and parasympathetic nervous systems responses (heart rate variability, pupillometry, skin conductance), electroencephalographic changes, and muscular reflex arc. Each monitor carries its own advantages and disadvantages. The manuscript aims to give an overview of the most up-to-date information available in the literature on current nociceptor monitors available in clinical practice, with particular focus on their applications in pediatrics.
摘要:
术中伤害性感受与患者发病率增加之间的关联已得到证实。然而,血液动力学参数,比如心率和血压,可能导致在手术过程中伤害感受监测不足。在过去的二十年里,不同的设备已经上市,以“可靠地”检测术中伤害感受。由于在手术过程中直接测量伤害性是不切实际的,这些监测仪测量伤害感受替代品,如交感神经和副交感神经系统反应(心率变异性,瞳孔测量,皮肤电导),脑电图改变,和肌肉反射弧。每个显示器都有自己的优点和缺点。该手稿旨在概述有关临床实践中可用的当前伤害感受器监测器的文献中可用的最新信息。特别关注它们在儿科中的应用。