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Related Concept Videos

Nociception01:44

Nociception

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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Nociception Along With Interventional Bronchoscopy: Analyzed With Analgesia Nociception Index.

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Topical anesthesia (TA) effectively manages nociception during interventional bronchoscopy (IB). This study shows TA reduces patient responses, aiding anesthetic management for smoother procedures.

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Area of Science:

  • Anesthesiology
  • Respiratory Medicine
  • Pain Management

Background:

  • Interventional bronchoscopy (IB) anesthesia is challenging due to unpredictable patient responses like coughing and desaturation.
  • The role of nociception and topical anesthesia (TA) in IB procedures remains under-investigated.
  • Understanding nociception timing and TA's impact is crucial for optimizing IB anesthesia.

Purpose of the Study:

  • To map the timing and intensity of nociception during IB.
  • To determine the onset of action for TA.
  • To clarify TA's effectiveness in blocking nociception during IB.

Main Methods:

  • Utilized Analgesia Nociception Index (ANI) and Mean Arterial Blood Pressure (MBP) in 82 patients.
  • Monitored patients under Bispectral Index (BIS)-controlled intravenous anesthesia during IB.
  • Collected data during anesthetic induction, iGel insertion, fibro-optic bronchoscopy (FOB) insertion, and TA (xylocaine) application using the spray-as-you-go (SAYGO) method.

Main Results:

  • iGel insertion significantly decreased ANI (P < 0.001).
  • SAYGO method significantly reduced ANI (P < 0.001), which returned to baseline within 5 minutes.
  • Mean arterial blood pressure changes mirrored ANI trends; no correlation found between BIS and ANI.

Conclusions:

  • ANI provides valuable insights into nociception, aiding anesthetic management for IB.
  • TA effectively blocks nociception during IB procedures.
  • Administering a short-acting anesthetic before FOB insertion is suggested to enhance TA's effect and ensure smooth procedures.