Toward a new approach for the detection of pain in adult patients undergoing cardiac surgery: near-infrared spectroscopy--a pilot study

Heart Lung. 2010 Nov-Dec;39(6):485-93. doi: 10.1016/j.hrtlng.2009.10.018. Epub 2010 Apr 24.

Abstract

Objective: This pilot study examined the discriminant validity and criterion validity of regional cerebral oxygenation measurement (rSO₂), using the near-infrared spectroscopy (NIRS) technique (INVOS-4100 system, Somanetics, Troy, MI) for measuring pain during nociceptive procedures in adults undergoing cardiac surgery.

Methods: A repeated-measures, within-subjects design was used, and 40 adult patients participated. Data collection was completed during 2 test periods: (1) while patients were awake, before the induction of anesthesia (first test period); and (2) after the induction of anesthesia, while patients remained under the effects of anesthesia (second test period). Each test period included a baseline, a tactile stimulus (skin disinfection), nociceptive stimuli (e.g., intravenous and arterial line insertions, sternal bone incision and thorax opening), and a postprocedure evaluation.

Results: Increased rSO₂ values (P < .001) were acquired during nociceptive procedures in both test periods. No significant associations were evident between rSO₂, pain behaviors, and the patient's self-report of pain intensity, but this may be attributable to a low range of variability.

Conclusions: Although further research is needed in critically ill adult patients undergoing more painful procedures, the NIRS may become a promising technique for assessing pain.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia / methods
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / surgery
  • Cardiovascular Surgical Procedures / psychology*
  • Cerebrovascular Circulation*
  • Critical Care
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Narcotics / therapeutic use
  • Nociceptors
  • Pain / diagnosis*
  • Pain / etiology
  • Pain Measurement
  • Pilot Projects
  • Reproducibility of Results
  • Spectroscopy, Near-Infrared / instrumentation
  • Spectroscopy, Near-Infrared / methods*
  • Statistics as Topic

Substances

  • Narcotics
  • Morphine