The importance and options of peroperative evaluation of nociception

Czech version

Authors: V.- Rogozov ^{1 4}; T. Vaněk ^1,2
Authors‘ workplace: Kardiochirurgická klinika, Fakultní nemocnice Královské Vinohrady, Praha ¹; 3. lékařská fakulta, Univerzita Karlova, Praha ²; Department of Anaesthesia, Leeds Teaching Hospitals, Leeds ³; School of Medicine, University of Leeds, Leeds ⁴
Published in: Anest. intenziv. Med., 31, 2020, č. 5, s. 225-232
Category: Review Articles

Overview

The main objective of anaesthetic care is to ensure safe and adequate anaesthesia and analgesia during surgery. By „safe” we mean full reversibility of the induced arteficial state while maintaining full integrity of the organism (in which the crucial role is represented by the maintenance of adequate supply of oxygen and organ perfusion). The term „adequate” refers to the goal of effective suppression of consciousness and nociception while minimizing adverse side effects of anaesthetics and analgesics, i.e. using the minimum effective dose of anaesthetic and analgesic. For such defined qualities, the authors propose the concept of euanaesthesia and euanalgesia. One of the main goals of perioperative anaesthetic care is to achieve effective supression of consciousness and nociception using the lowest effective doses of anaesthetics and analgesics. While monitoring of depth of anaesthesia has gone through a lot of progress and now allows routine targeted dosing of anaesthetics, reliable monitoring of nociception is still waiting for a major breakthrough. This article summarizes the importance of an individualized approach in anaesthetic care and provides an overview of currently available methods used for objective measure of nociception.

Keywords:

anaesthesia – analgesia – Nociception – monitoring – euanaesthesia – euanalgesia

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