• Kensuke Yanabe, Ryuji Nakamura, Noboru Saeki, Elbegzaya Sukhdorj, Abdugheni Kutluk, Hiroki Hirano, Harutoyo Hirano, Masao Yoshizumi, Toshio Tsuji, and Masashi Kawamoto.
• Division of Clinical Medical Sciences, Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
• Minerva Anestesiol. 2018 Mar 1; 84 (3): 311-318.

BackgroundReliable analgesia monitoring is not available for general anaesthesia cases. In 2003, we introduced a method to characterise arterial mechanical properties, which we termed arterial stiffness (K). However, it is unclear whether differences in K actually indicate changes in the intensity of a noxious stimulus. Thus, we examined the relationship between stress intensity and the value of K.MethodsThirty patients under general anesthesia were randomly divided into two remifentanil concentration groups (2 and 6 ng/mL). After a steady concentration of remifentanil was achieved for at least 3 minutes, laryngoscopy was performed. After completion of laryngoscopy, once the K value returned to near-baseline, laryngoscopy with endotracheal intubation was performed, and the value of K after the procedure was recorded and analyzed.ResultsIn total, data were obtained for 28 of 30 patients. The values of K before the laryngoscopy were not significantly different between the groups (2 ng/mL group: 13.1 [8.5-33.1] mmHg/%; 6 ng/mL group: 11.6 [4.3-31.4] mmHg/%; P=0.53). After laryngoscopy, K was approximately 2 times greater in the 2 ng/mL group than in the 6 ng/mL group (39.0 [13.6-115.9] mmHg/% vs. 19.0 [5.5-85.1] mmHg/%, P=0.02). After intubation also, K was approximately 2 times greater in the 2 ng/mL group (52.0 [27.7-122.0] mmHg/% vs. 24.3 [7.2-94.9] mmHg/%, P=0.04).ConclusionsThe value for arterial stiffness (K) non-proportionally changes in response to stimulus intensity; therefore, it has the potential to be used as an indicator of nociceptive stimulation intensity.

24 keywords...

hide…