• Best Pract Res Clin Anaesthesiol · Dec 2017

    Review

    Do we feel pain during anesthesia? A critical review on surgery-evoked circulatory changes and pain perception.

    • A Cividjian, F Petitjeans, N Liu, M Ghignone, M de Kock, and L Quintin.
    • Anesthesiology, Hôpital D'Instruction des Armées Desgenettes, Lyon, France; Alpha-2 Ltd, Lyon, France.
    • Best Pract Res Clin Anaesthesiol. 2017 Dec 1; 31 (4): 445-467.

    AbstractThe difficulty of defining the three so-called components of « an-esthesia » is emphasized: hypnosis, absence of movement, and adequacy of anti-nociception (intraoperative « analgesia »). Data obtained from anesthetized animals or humans delineate the activation of cardiac and vasomotor sympathetic reflex (somato-sympathetic reflex) and the cardiac parasympathetic deactivation observed following somatic stimuli. Sympathetic activation and parasympathetic deactivation are used as monitors to address the adequacy of intraoperative anti-nociception. Finally, intraoperative nociception through the administration of nonopioid analgesics vs. opioid analgesics is considered to achieve minimal postoperative side effects.Copyright © 2017 Elsevier Ltd. All rights reserved.

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