[Diagnosis of the autonomic nervous function during sedation by peripheral blood flow and psychogenic perspiration].
BACKGROUND
Pain induces a variety of physiological responses, many of which are mediated by the sympathetic nervous system. Among these are a reduction in peripheral blood flow and evaporative cutaneous water loss (sweating). We therefore tested the hypothesis that adequate sedation obliterates the normal pain-induced reduction in peripheral blood flow and an increase in evaporative water loss.


METHODS
We studied eight volunteers. Two different painful stimuli were randomly applied: 1) electrical pulp stimulation (200 microamperes) and 2) electrical pain stimulation on the right upper thigh (80 mA). Conscious sedating was controlled by propofol infusion titrated to a Bispectral Index near 80, or near 60.


RESULTS
At each stimulation, peripheral blood flow detected by laser Doppler decreased without any relation to the level of consciousness (by Bispectral Index). On the other hand, although the psychogenic perspiration rate increased significantly at alert level, during BIS 80 or 60 level, the increase was not significant.


CONCLUSIONS
Peripheral blood flow reacts most to pain stimulation during intravenous sedation.
Nishihara
Noboru
N
Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, School of Medicine, Tokyo 162-8666.
Iwakiri
Hiroko
H
Ogiuchi
Hideki
H
Ozaki
Makoto
M
D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D001775:Blood Circulation / Q000502:physiology*; D016292:Procedural Sedation; D004558:Electric Stimulation; D006339:Heart Rate; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D010147:Pain Measurement; D013546:Sweating / Q000502:physiology
D006993:Hypnotics and Sedatives