Monitoring of nociception, reality or fiction?
There are currently various projects underway that attempt to monitor the nociceptive responses caused by surgical stress and ensure patients the best analgesic conditions. The systemic response to surgical stress has repercussions in the postoperative period, such as worse pain control, delayed recovery, greater complications, longer stay in resuscitation and hospital units, and increased healthcare costs. However, treatment with higher doses of opioids than necessary may lead to slower awakening, increased drowsiness and adverse effects, as well as situations of postoperative opioid-induced hyperalgesia. There are 2 large groups of nociceptive monitoring according to the origin of the theoretical objective of monitoring response to the stimulus, that may derive from changes in the electroencephalogram or the response of the autonomic nervous system.
Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España. Electronic address: alfredoabadgurumeta@gmail.com.
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Abad-Gurumeta
Servicio de Anestesiología y Reanimación, Hospital Universitario Infanta Leonor, Madrid, España.
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Ripollés-Melchor
Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
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Casans-Francés
Servicio de Anestesiología y Reanimación, Hospital Universitario de Salamanca, Salamanca, España.
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Calvo-Vecino
D004569:Electroencephalography; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D059225:Nociception / Q000502:physiology*
Analgesia nociception index; Composite variability index; Entropía espectral; Monitorización de la nocicepción; Nociception monitoring; Pupillometry; Pupilometría; Spectral entropy; Surgical pleth index; qNOX; Índice de pletismografía quirúrgico; Índice de variabilidad compuesto