Developing novel technologies to monitor nociception and opioid administration during surgery and general anesthesia in order to minimize post-operative opioid requirements

开发新技术来监测手术和全身麻醉期间的伤害感受和阿片类药物的给药，以尽量减少术后阿片类药物的需求

• 批准号: 10157621
• 负责人: Tuan Le Mau
• 金额: $ 34.99万
• 依托单位: PASCALL SYSTEMS, INCORPORATED
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10157621
• 关键词: Algorithms; Americas; Analgesics; Anesthesia procedures; Anesthetics; Antihypertensive Agents; Applications Grants; Arousal; Blood Pressure; Caring; Chronic; Clinical; Clinical Data; Data; Dose; Electroencephalogram; Electroencephalography; Galvanic Skin Response; General Anesthesia; Heart Rate; Hemorrhage; Incidence; Lead; Length of Stay; Light; Measures; Methods; Monitor; Morphine; Nociception; Nociceptive Stimulus; Operative Surgical Procedures; Opiate Addiction; Opioid; Opioid Analgesics; Outcome; Patients; Pharmaceutical Preparations; Phase; Physiological; Postoperative Pain; Postoperative Period; Process; Public Health; Regulatory Pathway; Risk Factors; Small Business Technology Transfer Research; Surgeon; System; Time; Uncertainty; Ventilatory Depression; Wireless Technology; base; central sensitization; cognitive recovery; demographics; design; feature extraction; improved; indexing; neurophysiology; new technology; novel; opioid epidemic; opioid overdose; pain score; prescription opioid; product development; prospective; response; sensor; signal processing; tool

PROJECT SUMMARY In light of the opioid crises, minimizing postoperative pain and postoperative opioid requirements to reduce chronic opioid dependency among surgical patients have become major concerns for surgeons and anesthesiologists. Effective intraoperative nociception control can mitigate these concerns. Unfortunately, existing nociceptive monitoring tools use indicators that are inherently susceptible to intraoperative influences. Monitoring these indicators often lead to suboptimal intraoperative opioid administration, since there is no way to account for whether these measures are being influenced by nociception or numerous other intraoperative factors such as blood loss, anesthetic drugs and antihypertensives. Therefore, improved methods to monitor surgical nociception are clearly needed. In short, currently available nociceptive monitors measure unreliable indicators and predispose surgical patients to suboptimal opioid dosing administration leading to ineffective intraoperative control. The consequences for surgical patients can be significant, since increased postoperative pain and opioid requirements is associated with increased incidence of opioid dependency. This project proposes to develop a state-of-the-art sensors, algorithms, and prospective observational data to construct an integrated measure of nociceptive control based on autonomic (EDA) and neurophysiologic markers of arousal and nociception (EEG-based arousal and opioid signatures).

项目摘要 鉴于阿片类药物危机，最大程度地减少了术后疼痛和术后阿片类药物的需求以减少 外科患者之间的慢性阿片类药物依赖性已成为外科医生的主要关注点 麻醉学家。有效的术中伤害感受控制可以减轻这些关注点。很遗憾， 现有的伤害性监测工具使用固有地受到术中影响的指标。 监测这些指标通常会导致术中术中阿片类药物的给药，因为没有办法 解释这些措施是受伤害感受还是许多其他术中的影响 诸如失血，麻醉药物和抗高血压的因素。因此，改进的监视方法 显然需要手术伤害感受。简而言之，目前可用的伤害性监测器测量不可靠 指标和易于手术患者对阿片类药物剂量施用次级给药，导致无效 术中控制。手术患者的后果可能很大，因为术后增加 疼痛和阿片类药物的需求与阿片类药物依赖性的发生率增加有关。这个项目 建议开发最先进的传感器，算法和前瞻性观察数据，以构建 基于自主神经（EDA）和神经生理标记的伤害性控制的综合度量 和伤害感受（基于EEG的唤醒和阿片类药物特征）。