Anew arterial mechanical property indicator reflecting differences in invasive stimulus intensity induced by alteration of remifentanil concentration during laryngoscopy

Kensuke Yanabe, Ryuji Nakamura, Noboru Saeki, Elbegzaya Sukhdorj, Abdugheni Kutluk, Hiroki Hirano, Harutoyo Hirano, Masao Yoshizumi, Toshio Tsuji, Masashi Kawamoto

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

BACKGROUND: Reliable 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. METHODS: Thirty 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. RESULTS: In 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). CONCLUSIONS: The 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.

Original languageEnglish
Pages (from-to)311-318
Number of pages8
JournalMinerva Anestesiologica
Volume84
Issue number3
DOIs
Publication statusPublished - 03-2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

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