Developing novel technologies to monitor nociception and opioid administration during surgery and general anesthesia in order to minimize post-operative opioid requirements

项目总结 针对阿片类药物危象，尽量减少术后疼痛和术后阿片类药物需求 外科患者对阿片类药物的慢性依赖已成为外科医生和 麻醉师。有效的术中伤害性控制可以减轻这些担忧。不幸的是， 现有的伤害性监测工具使用的指标本身就容易受到术中影响。 监测这些指标往往导致术中阿片类药物给药不理想，因为没有办法 以说明这些措施是否受到伤害性或许多其他术中因素的影响 失血、麻醉药和降压药等因素。因此，改进了监测方法 外科手术的伤害性显然是必要的。简而言之，目前可用的伤害性监测器测量的不可靠 指标和容易使外科患者给药不佳的阿片类药物导致无效 术中控制。手术患者的后果可能是显著的，因为术后增加 疼痛和阿片类药物需求与阿片类药物依赖发生率增加有关。这个项目 建议开发一种最先进的传感器、算法和预期观测数据来构建 基于自主神经(EDA)和觉醒神经生理标记物的伤害性控制综合测量 和痛觉(基于脑电的唤醒和阿片类药物特征)。

PROJECT SUMMARY In light of the opioid crises, minimizing postoperative pain and postoperative opioid requirements to reduce chronic opioid dependency among surgical patients have become major concerns for surgeons and anesthesiologists. Effective intraoperative nociception control can mitigate these concerns. Unfortunately, existing nociceptive monitoring tools use indicators that are inherently susceptible to intraoperative influences. Monitoring these indicators often lead to suboptimal intraoperative opioid administration, since there is no way to account for whether these measures are being influenced by nociception or numerous other intraoperative factors such as blood loss, anesthetic drugs and antihypertensives. Therefore, improved methods to monitor surgical nociception are clearly needed. In short, currently available nociceptive monitors measure unreliable indicators and predispose surgical patients to suboptimal opioid dosing administration leading to ineffective intraoperative control. The consequences for surgical patients can be significant, since increased postoperative pain and opioid requirements is associated with increased incidence of opioid dependency. This project proposes to develop a state-of-the-art sensors, algorithms, and prospective observational data to construct an integrated measure of nociceptive control based on autonomic (EDA) and neurophysiologic markers of arousal and nociception (EEG-based arousal and opioid signatures).