Pain sensitivity: a feasible way to predict the intensity of stress reaction caused by endotracheal intubation and skin incision?

Wang, Hai-Tang; Cai, Ye-Hua; Liu, Jingchen; Dong, Yinv; Lai, Jian

doi:10.1007/s00540-015-2040-x

Cited by 5 publications

(5 citation statements)

References 30 publications

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“… 33 However, a previous study suggested that the patient’s response to pain after anesthesia induction has a significant relationship with preoperative pain tolerance. 28 These findings support our assumption that the withdrawal reaction is associated with the patients’ pain-related symptoms and EA in this study.…”

Section: Discussionsupporting

confidence: 90%

“… 26 Moreover, it has been demonstrated that an increased pain score for supra-threshold noxious stimulation has a better predictive value than pain thresholds. 26 , 27 Furthermore, authentic pain stimuli reflect pain tolerance more closely than pain threshold, 28 suggesting that they can be utilized as a representative of supra-threshold noxious stimuli. In human beings, the peripheral veins are innervated by polymodal nociceptors, which mediate the signal transmission for the injection pain of certain agents.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial

Kim

Roh

Lee

et al. 2018

TCRM

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PurposeThe development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA.MethodsA total of 40 patients were enrolled in this study. During anesthesia induction, the withdrawal reaction after loss of consciousness following rocuronium injection was assessed using a 4-point scale. After surgery, EA was assessed using the Watcha scale.ResultsThere was a correlation between withdrawal reaction and EA on admission to the postanesthesia care unit (PACU). Patients with a severe withdrawal reaction (grade 3) showed a significantly higher incidence of severe EA requiring medication on admission to the PACU.ConclusionThe findings of this preliminary exploratory observational study suggest that it is possible for withdrawal movement following rocuronium injection during anesthesia induction to reflect pain sensitivity of pediatric patients, which in turn may be useful in identifying those at risk of severe EA on admission to the PACU among preschool children undergoing inguinal herniorrhaphy. Further studies with a larger sample size are required to validate these findings. The exact correlation between pain reaction following rocuronium injection and postoperative pain or pain-related phenomenon should be elucidated.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial

Kim

Roh

Lee

et al. 2018

TCRM

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“…Anesthetic requirements might be affected by individual nociception during the surgical procedure. Wang et al [22] reported that patients' preoperative pain sensitivity was correlated with their stress response during endotracheal intubation and skin incision. Pain tolerance was negatively correlated with changes in BP, HR, and plasma norepinephrine level before and after intubation and skin incision.…”

Section: Discussionmentioning

confidence: 99%

Relationship between intraoperative requirement for inhalational anesthetic or opioid and postoperative analgesic consumption: a randomized controlled study

Lee,

Doo,

et al. 2023

Preprint

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Background This study investigated the relationship between intraoperative requirement for an inhalational anesthetic (sevoflurane) or an opioid (remifentanil) and postoperative analgesic consumption. Methods The study included 200 adult patients undergoing elective laparoscopic colectomy. In the sevoflurane group, the effect-site concentration of remifentanil was fixed at 1.0 ng/ml, while the inspiratory sevoflurane concentration was adjusted to maintain an appropriate anesthetic depth. In the remifentanil group, the end-expiratory sevoflurane concentration was fixed at 1.0 volume%, and the remifentanil concentration was adjusted. Pain scores and cumulative postoperative analgesic consumptions were evaluated at 2, 6, 24, and 48 h after surgery. Results Average end-tidal concentration of sevoflurane and effect-site concentration of remifentanil were 2.0 ± 0.4 volume% and 3.9 ± 1.4 ng/ml in the sevoflurane and remifentanil groups, respectively. Cumulative postoperative analgesic consumption at 48 h postoperatively was 55 ± 26 ml in the sevoflurane group and 57 ± 33 ml in the remifentanil group. In the remifentanil group, the postoperative cumulative analgesic consumptions at 2 and 6 h were positively correlated with intraoperative remifentanil requirements (2 h: r = 0.36, P < 0.01; 6 h: r = 0.38, P < 0.01). However, there was no significant correlation in the sevoflurane group (r = 0.04, P = 0.69). Conclusion The amount of intraoperative requirement of short acting opioid, remifentanil, is correlated with postoperative analgesic consumption within postoperative 6 h. It may be contributed by the development of acute opioid tolerance. However, intraoperative sevoflurane requirement had no effect on postoperative analgesic consumption. Trial registration: KCT0004743

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“…Anesthetic requirements might be affected by individual nociception during the surgical procedure. Wang et al [ 12 ] reported that patients’ preoperative pain sensitivity was correlated with their stress response during endotracheal intubation and skin incision. Pain tolerance was negatively correlated with changes in blood pressure (BP), heart rate (HR), and plasma norepinephrine level before and after intubation and skin incision.…”

Section: Introductionmentioning

confidence: 99%

Relationship between intraoperative requirement for anesthetics and postoperative analgesic consumption in laparoscopic colectomy: a randomized controlled double-blinded study

Lee,

Doo,

et al. 2024

Anesth Pain Med

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Background: This study investigated the relationship between intraoperative requirement for an inhalational anesthetic (sevoflurane) or an opioid (remifentanil) and postoperative analgesic consumption. Methods: The study included 200 adult patients undergoing elective laparoscopic colectomy. In the sevoflurane group, the effect-site concentration of remifentanil was fixed at 1.0 ng/ml, while the inspiratory sevoflurane concentration was adjusted to maintain an appropriate anesthetic depth. In the remifentanil group, the end-expiratory sevoflurane concentration was fixed at 1.0 volume%, and the remifentanil concentration was adjusted. Pain scores and cumulative postoperative analgesic consumptions were evaluated at 2, 6, 24, and 48 h after surgery. Results: Average end-tidal concentration of sevoflurane and effect-site concentration of remifentanil were 2.0 ± 0.4 volume% and 3.9 ± 1.4 ng/ml in the sevoflurane and remifentanil groups, respectively. Cumulative postoperative analgesic consumption at 48 h postoperatively was 55 ± 26 ml in the sevoflurane group and 57 ± 33 ml in the remifentanil group. In the remifentanil group, the postoperative cumulative analgesic consumptions at 2 and 6 h were positively correlated with intraoperative remifentanil requirements (2 h: r = 0.36, P < 0.01; 6 h: r = 0.38, P < 0.01). However, there was no significant correlation in the sevoflurane group (r = 0.04, P = 0.69). Conclusions: The amount of intraoperative requirement of short acting opioid, remifentanil, is correlated with postoperative analgesic consumption within postoperative 6 h. It may be contributed by the development of acute opioid tolerance. However, intraoperative sevoflurane requirement had no effect on postoperative analgesic consumption.

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Pain sensitivity: a feasible way to predict the intensity of stress reaction caused by endotracheal intubation and skin incision?

Abstract: Pain tolerance had a significant relationship with stress response during intubation and skin incision. We may initially use pain tolerance to direct opioid usage in the future.

Cited by 5 publications

References 30 publications

Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial

Prediction of emergence agitation using withdrawal reaction following rocuronium injection in preschool-aged patients undergoing inguinal herniorrhaphy: a preliminary exploratory observational trial

Relationship between intraoperative requirement for inhalational anesthetic or opioid and postoperative analgesic consumption: a randomized controlled study

Relationship between intraoperative requirement for anesthetics and postoperative analgesic consumption in laparoscopic colectomy: a randomized controlled double-blinded study

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