相关实验视频

Updated: Jun 27, 2025

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

Published on: July 4, 2018

评估接受神经肌肉阻断剂的重病患者的疼痛:一个单中心的潜在队列

Jules Voeltzel¹, Océane Garnier¹, Albert Prades¹

¹Department of Anaesthesia & Critical Care Medicine, Saint Eloi Montpellier University Hospital, and PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.

Anaesthesia, critical care & pain medicine

|May 6, 2024

概括

疼痛感知指数 (ANI) 有效地检测了接受神经肌肉阻断剂的静止ICU患者的疼痛. 在痛苦的手术过程中,NI显示出显著的变化,无论,使其成为可靠的疼痛评估工具.

科学领域:

关键护理医学关键护理医学
疼痛管理疼痛管理
神经生理学神经生理学

背景情况:

对药理学患者的重症监护室 (ICU) 疼痛评估缺乏确定的指导方针.
神经肌肉阻断剂 (NMBA) 会使重症患者的疼痛评估复杂化.

研究的目的:

评估电生理学和临床参数对接受NMBA治疗的ICU患者疼痛评估的有效性.
确定神经肌肉阻塞期间和之后这些参数的可靠性.

主要方法:

五个参数进行了比较:疼痛感知指数 (ANI),双光谱指数 (BIS),心率 (HR),平均动脉血压 (ABP) 和行为疼痛量表 (BPS).
在接受cisatracurium的麻和非麻ICU患者的气管吸管过程中记录的参数.
评估了分辨剂的有效性 (感知过程中的参数变化) 和可靠性 (的影响).

主要成果:

在这两种状态下,气管吸管过程中,ANI,BIS和HR发生了显著的变化.
ANI和HR不受神经肌肉阻塞的影响,与BIS和BPS不同.
ANI显示了最高的分辨器有效性,在和非患者的气管吸收过程中显示显著下降.

结论:

疼痛感知指数 (ANI) 是最有区别的参数来检测静止ICU患者的疼痛,无论神经肌肉阻塞.
在 nociceptive 程序期间检测疼痛的 ANI 的有效性不会因使用NMBA而改变.
在接受NMBA的ICU患者的疼痛评估中,ANI显示出作为可靠的疼痛评估工具的潜力,等待对止痛方案的进一步研究.

关键词:

止痛药止痛药是一种止痛药.在重症监护病房的重症监护病房.神经肌肉阻断剂是一种神经肌肉阻断剂.疼痛疼痛疼痛疼痛麻是一种麻.镇静镇静镇静镇静

更多相关视频

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Published on: April 12, 2011

相关概念视频

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...

Classification of Skeletal Muscle Relaxants

Classification of Skeletal Muscle Relaxants

Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...

Skeletal Muscle Relaxants: Adverse Effects

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...

Depolarizing Blockers: Pharmocokinetics

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...

Depolarizing Blockers: Mechanism of Action

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...