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Characterization of the functional near‐infrared spectroscopy response to nociception in a pediatric population
Author(s) -
Olbrecht Vanessa A.,
Jiang Yifei,
Viola Luigi,
Walter Charlotte M.,
Liu Hanli,
Kurth Charles D.
Publication year - 2018
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13301
Subject(s) - medicine , nociception , anesthesia , fentanyl , sevoflurane , population , functional near infrared spectroscopy , stimulation , propofol , prefrontal cortex , receptor , cognition , environmental health , psychiatry
Summary Background Near‐infrared spectroscopy can interrogate functional optical signal changes in regional brain oxygenation and blood volume to nociception analogous to functional magnetic resonance imaging. Aims This exploratory study aimed to characterize the near‐infrared spectroscopy signals for oxy‐, deoxy‐, and total hemoglobin from the brain in response to nociceptive stimulation of varying intensity and duration, and after analgesic and neuromuscular paralytic in a pediatric population. Methods We enrolled children 6 months‐21 years during propofol sedation before surgery. The near‐infrared spectroscopy sensor was placed on the forehead and nociception was produced from an electrical current applied to the wrist. We determined the near‐infrared spectroscopy signal response to increasing current intensity and duration, and after fentanyl, sevoflurane, and neuromuscular paralytic. Heart rate and arm movement during electrical stimulation was also recorded. The near‐infrared spectroscopy signals for oxy‐, deoxy‐, and total hemoglobin were calculated as optical density*time (area under curve). Results During electrical stimulation, nociception was evident: tachycardia and arm withdrawal was observed that disappeared after fentanyl and sevoflurane, whereas after paralytic, tachycardia persisted while arm withdrawal disappeared. The near‐infrared spectroscopy signals for oxy‐, deoxy‐, and total hemoglobin increased during stimulation and decreased after stimulation; the areas under the curves were greater for stimulations 30 mA vs 15 mA (13.9 [5.6‐22.2], P = .0021; 5.6 [0.8‐10.5], P = .0254, and 19.8 [10.5‐29.1], P = .0002 for HbO 2 , Hb, and Hb T , respectively), 50 Hz vs 1 Hz (17.2 [5.8‐28.6], P = .0046; 7.5 [0.7‐14.3], P = .0314, and 21.9 [4.2‐39.6], P = .0177 for HbO 2 , Hb, and Hb T , respectively) and 45 seconds vs 15 seconds (16.3 [3.4‐29.2], P = .0188 and 22.0 [7.5‐36.5], P = .0075 for HbO 2 and Hb T , respectively); the areas under the curves were attenuated by analgesics but not by paralytic. Conclusion Near‐infrared spectroscopy detected functional activation to nociception in a broad pediatric population. The near‐infrared spectroscopy response appears to represent nociceptive processing because the signals increased with noxious stimulus intensity and duration, and were blocked by analgesics but not paralytics.