Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain

Lichtner, Gregor; Auksztulewicz, Ryszard; Kirilina, Evgeniya; Velten, H.; Mavrodis, D.; Scheel, Michael; Blankenburg, Felix; Dincklage, Falk von

doi:10.1016/j.neuroimage.2018.02.003

Cited by 28 publications

(39 citation statements)

References 71 publications

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“…Halothane is used as the inhalant anaesthetic of choice in the minimum anaesthesia model because it causes significantly less cortical activity depression compared to newer agents such as isoflurane, sevoflurane and desflurane at equivalent multiples of MAC (Murrell, Waters, & Johnson, 2008). Propofol, which was used as anaesthetic induction agent in this study, is associated with EEG burst suppression and unresponsiveness to noxious stimulation (Lichtner et al., 2018). However, it has a short duration of action (Fulton & Sorkin, 1995) and the noxious stimulus in this study was applied at 30 min after induction of anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Effect of combinations of morphine, dexmedetomidine and maropitant on the electroencephalogram in response to acute electrical stimulation in anaesthetized dogs

Karna

Chambers

Johnson

et al. 2020

Vet Pharm & Therapeutics

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This study was conducted to compare the efficacy of combinations of morphine, dexmedetomidine and maropitant in preventing the changes in electroencephalographic (EEG) indices of nociception in anaesthetized dogs subjected to a noxious electrical stimulus. In a crossover study, eight healthy adult dogs were randomly allocated to four groups: Mor: morphine 0.6 mg/kg; Dex + Mor: morphine 0.3 mg/kg + dexmedetomidine 5 μg/kg; Maro + Mor: morphine 0.3 mg/kg + maropitant 1 mg/kg; and Dex + Maro + Mor: morphine 0.2 mg/kg + dexmedetomidine 3 μg/kg + maropitant 0.7 mg/kg. Following intramuscular administration of test drugs in a minimal anaesthesia model, a supramaximal electrical stimulus (50 V at 50 Hz for 2 s) was applied and the EEG data were recorded. There were significant increases (p < .05) in the poststimulus median frequency (F50) only in groups Mor and Maro + Mor. Dex + Mor group had a significantly lower change in F50 and F95 compared to all other treatment groups. There was no correlation of the changes in EEG frequencies with blood plasma concentration of the drugs during and after noxious stimulation. Combination of dexmedetomidine and morphine was most effective in abolishing the changes in EEG indices in response to a noxious stimulus indicating a supra‐additive interaction between these two drugs.

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Section: Discussionmentioning

confidence: 99%

Effect of combinations of morphine, dexmedetomidine and maropitant on the electroencephalogram in response to acute electrical stimulation in anaesthetized dogs

Karna

Chambers

Johnson

et al. 2020

Vet Pharm & Therapeutics

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“…These ‘later acting’ cerebral regions are not only associated with working memory, but also appear to be involved in the cognitive act of rating pain magnitude, and may participate in pain control 32 . The neural mechanism underlying conscious pain can be conceptualized as a fluid system composed of several interacting networks with different temporal dynamics 9–11,23 . The a-Ins, DLPFC, aMCC and PPC are activated later than the first somatosensory network, which receives the noxious inputs from the periphery 14 .…”

Section: Discussionmentioning

confidence: 99%

“…The current concepts about cortical pain integration consider that there is, in the conscious appraisal of pain, a need to integrate sensory encoding with stimulus salience, executive control, memory encoding and self-awareness 9–13 . Thus, the neural mechanism of pain can be conceptualized as a system composed of multiple functional modules of brain regions interacting together to achieve different subgoals 9,11,14 . A ‘nociceptive subnetwork’ responsible for processing the sensory aspect of pain includes regions receiving input from the ascending spinothalamic tract (e.g., posterior operculo-insular regions and S1).…”

Section: Introductionmentioning

confidence: 99%

Brain activity sustaining the modulation of pain by empathetic comments

Fauchon

Faillenot

Quesada

et al. 2019

Sci Rep

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Empathetic verbal feedback from others has been shown to alleviate the intensity of experimental pain. To investigate the brain changes associated with this effect, we conducted 3T-fMRI measurements in 30 healthy subjects who received painful thermal stimuli on their left hand while overhearing empathetic, neutral or unempathetic comments, supposedly made by experimenters, via headsets. Only the empathetic comments significantly reduced pain intensity ratings. A whole-brain BOLD analysis revealed that both Empathetic and Unempathetic conditions significantly increased the activation of the right anterior insular and posterior parietal cortices to pain stimuli, while activations in the posterior cingulate cortex and precuneus (PCC/Prec) were significantly stronger during Empathetic compared to Unempathetic condition. BOLD activity increased in the DLPFC in the Empathetic condition and decreased in the PCC/Prec and vmPFC in the Unempathetic condition. In the Empathetic condition only, functional connectivity increased significantly between the vmPFC and the insular cortex. These results suggest that modulation of pain perception by empathetic feedback involves a set of high-order brain regions associated with autobiographical memories and self-awareness, and relies on interactions between such supra-modal structures and key nodes of the pain system.

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“…The oldest studies in that respect were event-related potential EEG studies (Uhl et al, 1980; Plourde and Boylan, 1991), and the fMRI or PET activation studies (Bonhomme et al, 2008). The most recent ones look into how the brain handles sensory information (Lichtner et al, 2018a,b; Nourski et al, 2018) and between-region communication (Darracq et al, 2018a), as well as the directionality of information transfer (Sanders et al, 2018), and sensory cross-modal interactions (Bekinschtein et al, 2009). Some mixed approaches exist, melting one mode of analysis with another, such as those measuring the spatio-temporal complexity of TMS-evoked cortical responses (Casali et al, 2013; Bodart et al, 2017).…”

Section: Several Ways Of Exploring the Effects Of Anesthetic Medicatimentioning

confidence: 99%

General Anesthesia: A Probe to Explore Consciousness

Bonhomme

Staquet

Montupil

et al. 2019

Front. Syst. Neurosci.

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General anesthesia reversibly alters consciousness, without shutting down the brain globally. Depending on the anesthetic agent and dose, it may produce different consciousness states including a complete absence of subjective experience (unconsciousness), a conscious experience without perception of the environment (disconnected consciousness, like during dreaming), or episodes of oriented consciousness with awareness of the environment (connected consciousness). Each consciousness state may potentially be followed by explicit or implicit memories after the procedure. In this respect, anesthesia can be considered as a proxy to explore consciousness. During the recent years, progress in the exploration of brain function has allowed a better understanding of the neural correlates of consciousness, and of their alterations during anesthesia. Several changes in functional and effective between-region brain connectivity, consciousness network topology, and spatio-temporal dynamics of between-region interactions have been evidenced during anesthesia. Despite a set of effects that are common to many anesthetic agents, it is still uneasy to draw a comprehensive picture of the precise cascades during general anesthesia. Several questions remain unsolved, including the exact identification of the neural substrate of consciousness and its components, the detection of specific consciousness states in unresponsive patients and their associated memory processes, the processing of sensory information during anesthesia, the pharmacodynamic interactions between anesthetic agents, the direction-dependent hysteresis phenomenon during the transitions between consciousness states, the mechanisms of cognitive alterations that follow an anesthetic procedure, the identification of an eventual unitary mechanism of anesthesia-induced alteration of consciousness, the relationship between network effects and the biochemical or sleep-wake cycle targets of anesthetic agents, as well as the vast between-studies variations in dose and administration mode, leading to difficulties in between-studies comparisons. In this narrative review, we draw the picture of the current state of knowledge in anesthesia-induced unconsciousness, from insights gathered on propofol, halogenated vapors, ketamine, dexmedetomidine, benzodiazepines and xenon. We also describe how anesthesia can help understanding consciousness, we develop the above-mentioned unresolved questions, and propose tracks for future research.

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Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain

Cited by 28 publications

References 71 publications

Effect of combinations of morphine, dexmedetomidine and maropitant on the electroencephalogram in response to acute electrical stimulation in anaesthetized dogs

Effect of combinations of morphine, dexmedetomidine and maropitant on the electroencephalogram in response to acute electrical stimulation in anaesthetized dogs

Brain activity sustaining the modulation of pain by empathetic comments

General Anesthesia: A Probe to Explore Consciousness

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