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Effect of the Location of Tetanic Stimulation on Autonomic Responses: A Randomized Cross-Over Pilot Study

Overview
Journal J Pain Res
Publisher Dove Medical Press
Date 2024 Jan 15
PMID 38223663
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Abstract

Background: Tetanic stimuli are used as standardized noxious inputs to investigate nociception. Previous studies have applied tetanic stimuli to various anatomical locations without validating that the resulting physiological responses were independent of the location where tetanic stimuli were applied. Our aim was to investigate the effects of three anatomical tetanic stimulus application sites on physiological variables reflecting autonomic nervous system responses as measured by photoplethysmography (PPG).

Methods: Under general anesthesia, a five second, 100 hertz, 70 milliamp tetanic stimulus was applied to the ulnar nerve, medial side of the tibia, and thorax (T5 dermatome) (N=12). The effect of tetanic stimuli on PPG-derived variables (AC, DC, and ACDC) and pulse rate at each stimulus location was determined using repeated-measures analysis of variance (ANOVA) followed by Dunnett's post hoc test. Maximum tetanic stimulus-induced changes in PPG-derived variables and pulse rates were compared among the three stimulus locations using ANOVA.

Results: AC and ACDC values of PPG decreased, and the DC values of PPG increased in response to tetanic stimuli-induced vasoconstriction at each location (<0.001 for all). The maximum changes in the AC, ACDC, and DC values did not differ between locations (=NS). There were no significant changes in pulse rate (=NS).

Conclusion: The results showed that tetanic stimulation at either of these three locations provides the same autonomic nervous system responses, as measured by PPG.

Clinical Trial Registration: ClinicalTrials.gov; NCT03648853.

References
1.
Talke P . The Effect of Tracheal Intubation-Induced Autonomic Response on Photoplethysmography. Anesthesiol Res Pract. 2017; 2017:7646541. PMC: 5392400. DOI: 10.1155/2017/7646541. View

2.
Talke P, Snapir A, Huiku M . The effects of sympathectomy on finger photoplethysmography and temperature measurements in healthy subjects. Anesth Analg. 2011; 113(1):78-83. DOI: 10.1213/ANE.0b013e318217f6b1. View

3.
Funcke S, Sauerlaender S, Pinnschmidt H, Saugel B, Bremer K, Reuter D . Validation of Innovative Techniques for Monitoring Nociception during General Anesthesia: A Clinical Study Using Tetanic and Intracutaneous Electrical Stimulation. Anesthesiology. 2017; 127(2):272-283. DOI: 10.1097/ALN.0000000000001670. View

4.
Cowen R, Stasiowska M, Laycock H, Bantel C . Assessing pain objectively: the use of physiological markers. Anaesthesia. 2015; 70(7):828-47. DOI: 10.1111/anae.13018. View

5.
Jablonka D, Awad A, Stout R, Silverman D, Shelley K . Comparing the effect of arginine vasopressin on ear and finger photoplethysmography. J Clin Anesth. 2008; 20(2):90-3. DOI: 10.1016/j.jclinane.2007.09.008. View