2014
DOI: 10.1111/pan.12586
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Monitoring depth of anesthesia: from consciousness to nociception. A window on subcortical brain activity

Abstract: Anesthesia results from several inhibitor processes, which interact to lead to loss of consciousness, amnesia, immobility, and analgesia. The anesthetic agents act on the whole brain, the cortical and subcortical areas according to their receptor targets. The conscious processes are rather integrated at the level of the cortical neuronal network, while the nonconscious processes such as the nociception or implicit memory require subcortical processing. A reliable and meaningful monitoring of depth of anesthesi… Show more

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Cited by 63 publications
(44 citation statements)
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“…During emergence, changes in both cortical and subcortical areas recover gradually. 19 The BIS values were lower in the Conversely, the PI values were higher in the unconscious state and it went lower when more conscious status has achieved ( Figure 2).…”
Section: Discussionmentioning
confidence: 93%
See 1 more Smart Citation
“…During emergence, changes in both cortical and subcortical areas recover gradually. 19 The BIS values were lower in the Conversely, the PI values were higher in the unconscious state and it went lower when more conscious status has achieved ( Figure 2).…”
Section: Discussionmentioning
confidence: 93%
“…The BIS is derived from spontaneous EEG reflecting changes in cortical area, while PI acts as an indicator of the plethysmographic pulse wave amplitude reflecting changes in subcortical zone. During emergence, changes in both cortical and subcortical areas recover gradually . The BIS values were lower in the unconscious state and rose higher toward baseline during awakening.…”
Section: Discussionmentioning
confidence: 99%
“…The small dose of the anaesthetics lead to suppressed thinking, focused attention and working memory. The increased anaestetic dose can act subcortical areas and suppress the nociceptive and autonomic reflexes [14,15].…”
Section: Discussionmentioning
confidence: 99%
“…where a = 5.1 and b = 1.2 have been determined on a set of patients in order to keep the visual coherence between the visual effect of respiration on the RR series and the quantitative importance of pS tone. ANI values decrease below 50 when pS tone decreases in response to an increased sympathetic activity, and have been related to an analgesia/nociception imbalance [21,[33][34][35][36][37][38]. The ANI monitor displays two values; an instantaneous values (ANIi) which represents the instantaneous response to a painful stimulus and an average ANI (ANIa) computed over 4 minutes which represent the state analgesia/nociception imbalance.…”
Section: Monitoring Analgesiamentioning
confidence: 99%