Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2016
Case ReportsElectroencephalographic evoked pain response is suppressed by spinal cord stimulation in complex regional pain syndrome: a case report.
Pain is a subjective response that limits assessment. The purpose of this case report was to explore how the objectivity of the electroencephalographic response to thermal stimuli would be affected by concurrent spinal cord stimulation. A patient had been implanted with a spinal cord stimulator for the management of complex regional pain syndrome of both hands for 8 years. ⋯ The patient reported a clinically significant reduction in thermal induced pain using the numerical rating scale (71.4 % reduction) with spinal cord stimulator switched on. Analysis of electroencephalogram recordings indicated the occurrence of contact heat evoked potentials (N2-P2) with spinal cord stimulator off, but not with spinal cord stimulator on. This case report suggests that thermal pain can be reduced in complex regional pain syndrome patients with the use of spinal cord stimulation and offers objective validation of the reported outcomes with this treatment.
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J Clin Monit Comput · Dec 2016
Ambient temperature effect on pulse rate variability as an alternative to heart rate variability in young adult.
Pulse rate variability (PRV) is a promising physiological and analytic technique used as a substitute for heart rate variability (HRV). PRV is measured by pulse wave from various devices including mobile and wearable devices but HRV is only measured by an electrocardiogram (ECG). The purpose of this study was to evaluate PRV and HRV at various ambient temperatures and elaborate on the interchangeability of PRV and HRV. ⋯ In our analysis the absolute value of PTT was not significantly influenced by temperature. Standard deviation of PTT, however, showed significant difference not only between low and moderate temperatures but also between low and high temperatures. Our results suggest that ambient temperature induces a significant difference in PRV compared to HRV and that the difference becomes greater at a higher ambient temperature.
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J Clin Monit Comput · Dec 2016
Effect-site concentrations of remifentanil causing bradycardia in hypnotic and non-hypnotic patients.
Although the induction of anaesthesia with remifentanil often causes bradycardia, the relationship between the effect-site concentration (Ce) of remifentanil and instantaneous heart rate (HR) has remained unclear. The present study examined the relationship between instantaneous HR and remifentanil Ce at the induction of anaesthesia with and without propofol hypnosis, to facilitate safe management of anaesthesia induction with remifentanil. Instantaneous HR was calculated every 5 s using an electrocardiographic real-time analysis system (MemCalc/Makin2; GMS, Tokyo, Japan). ⋯ In the hypnosis group, HR was significantly lower than basal HR when remifentanil Ce was increased to 3.5 ng ml(-1) (p < 0.05), whereas no significant HR reduction was found in the non-hypnosis group until remifentanil Ce reached >5 ng ml(-1) (p < 0.05). The induction of anaesthesia using remifentanil with propofol hypnotics significantly reduces HR even in a low remifentanil Ce insufficient to suppress the cardiovascular response at tracheal intubation. Preparations to treat bradycardia are recommended for the safe management of anaesthesia induction when remifentanil is combined with hypnotics.
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J Clin Monit Comput · Dec 2016
Editorial CommentCardiac output monitoring: less invasiveness, less accuracy?