Propofol and Analgesia

TerRiet, Menno F.; Jacobs, Jeffrey; Lewis, Michael C.; DeSouza, Gerard

doi:10.1097/00000539-200006000-00039

Cited by 6 publications

(6 citation statements)

References 1 publication

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“…With respect to nociceptive stimulation, it is interesting that areas normally showing attenuated BOLD responses with analgesia (thalamus, S1, anterior cingulate cortex, prefrontal cortex, posterior insula) were not attenuated. Propofol is however an anesthetic with weak if any analgesic action (TerRiet et al, 2000). Notably, no significant modulation of thalamic responses to either the auditory or thermal pain stimuli was observed.…”

Section: Discussionmentioning

confidence: 91%

Cortical and Subcortical Connectivity Changes during Decreasing Levels of Consciousness in Humans: A Functional Magnetic Resonance Imaging Study using Propofol

Mhuircheartaigh¹,

Rosenorn-Lanng²,

Wise³

et al. 2010

Journal of Neuroscience

198

144

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. We investigated the effects of propofol, widely used for anesthesia and sedation, on spontaneous and evoked cerebral activity using functional magnetic resonance imaging (fMRI). A series of auditory and noxious stimuli was presented to eight healthy volunteers at three behavioral states: awake, "sedated" and "unresponsive." Performance in a verbal task and the absence of a response to verbal stimulation, rather than propofol concentrations, were used to define these states clinically. Analysis of stimulus-related blood oxygenation level-dependent signal changes identified reductions in cortical and subcortical responses to auditory and noxious stimuli in sedated and unresponsive states. A specific reduction in activity within the putamen was noted and further investigated with functional connectivity analysis. Progressive failure to perceive or respond to auditory or noxious stimuli was associated with a reduction in the functional connectivity between the putamen and other brain regions, while thalamo-cortical connectivity was relatively preserved. This result has not been previously described and suggests that disruption of subcortical thalamo-regulatory systems may occur before, or even precipitate, failure of thalamo-cortical transmission with the induction of unconsciousness.

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Section: Discussionmentioning

confidence: 91%

Cortical and Subcortical Connectivity Changes during Decreasing Levels of Consciousness in Humans: A Functional Magnetic Resonance Imaging Study using Propofol

Mhuircheartaigh¹,

Rosenorn-Lanng²,

Wise³

et al. 2010

Journal of Neuroscience

198

144

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“…They seem to think propofol can replace adequate analgesia obtained by infiltration with local anesthesia. 45 Despite this debate many clinicians remain convinced that propofol could be effectively used as analgesic drug as recent reports about the use of propofol to treat pain indicate. 46-49 …”

Section: Discussionmentioning

confidence: 99%

Effect of Sedation on Pain Perception

Frölich

Zhang

Ness³

2013

Anesthesiology

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Background Sedation or anesthesia is used to facilitate many cases of an estimated 45 million diagnostic and therapeutic medical procedures in the United States. Preclinical studies have called attention to the possibility that sedative hypnotic drugs can increase pain perception but it remains unclear whether this observation holds true in humans and whether pain-modulating effects are agent specific or characteristic of intravenous sedation in general. Methods To study this important clinical question, we recruited 86 healthy volunteers and randomly assigned them to receive one of three sedative drugs; midazolam, propofol or dexmedetomidine. We asked participants to rate their pain in response to four experimental pain tasks (cold, heat, ischemic or electrical pain) before and during moderate sedation. Results Midazolam increased cold, heat and electrical pain perception significantly (10-point pain rating scale change = 0.82 ± 0.29, mean ± SEM). Propofol reduced ischemic pain and dexmedetomidine reduced both cold and ischemic pain significantly (−1.58 ± 0.28, mean ± SEM). We observed a gender-by-race interaction for dexmedetomidine. In addition to these drug specific effects, we observed gender effects on pain perception; females rated identical experimental pain stimuli higher than males. We also noted racedrug interaction effects for dexmedetomidine with higher doses of drug needed to sedate Caucasians when compared to African-Americans. Conclusions The results of our study call attention to the fact that intravenous sedatives may increase pain perception. The effect of sedation on pain perception is agent and pain type specific. Knowledge of these effects provides a rational basis for analgesia and sedation to facilitate medical procedures.

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“…General anesthesia refers to a drug‐induced unconscious state accompanied by amnesia, muscle relaxation, and analgesia 7 . Propofol may affect pain control after surgery 8,9 ; however, it is generally known not to have an analgesic or muscle relaxation effect 10,11 . Volatile anesthetics are known to have such effects, as well as the ability to cause unconsciousness and amnesia 12 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

Kang

Park

et al. 2023

Pediatric Anesthesia

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Background:The light reflex, which reflects central nervous system dysfunction, can also be affected by anesthetic agents. Aims:We evaluated whether these effects differed according to the anesthetic agent in pediatric patients.Methods: Twenty children aged 3-12 years who were scheduled to undergo elective surgery under general anesthesia were randomly allocated to propofol and sevoflurane groups and underwent pupillometric assessments at five points during anesthesia: T1, after confirming loss of consciousness; T2, after endotracheal intubation; T3, at the time of skin incision; T4, 1 h after skin incision; and T5, before endotracheal extubation. The primary outcome was the Neurological Pupil index at T4, and the secondary outcomes were other pupillometric parameters, including pupil diameter, percentage of change in pupil diameter, dilation velocity, and constriction velocity.Results: At T4, the Neurological Pupil index was significantly lower in the sevoflurane group (median difference, 0.30; 95% CI, 0.00 to 0.70; p = .036). Furthermore, the Neurological Pupil index at all time points was lower in the sevoflurane group. The timeand-group interaction effects on constriction velocity and dilation velocity were significantly different [F(1, 4) = 16.68, p = .002; F(1, 4) = 14.78, p = .008, respectively] but were not different on the Neurological Pupil index, pupil diameter, and percentage of change in pupil diameter. No intergroup differences were observed in the baseline characteristics, the flow rate of remifentanil at each time point, and total infused remifentanil. Conclusion:The Neurological Pupil index value in pediatric patients under general anesthesia is affected by the anesthetic agent used; this factor requires consideration in evaluations of the Neurological Pupil index during general anesthesia.

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Propofol and Analgesia

Cited by 6 publications

References 1 publication

Cortical and Subcortical Connectivity Changes during Decreasing Levels of Consciousness in Humans: A Functional Magnetic Resonance Imaging Study using Propofol

Cortical and Subcortical Connectivity Changes during Decreasing Levels of Consciousness in Humans: A Functional Magnetic Resonance Imaging Study using Propofol

Effect of Sedation on Pain Perception

Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

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