Effect of functional near-infrared spectroscopy in pain assessment under general anesthesia

JIN Chenyan; GUO Hang; LI Qinghua; LI Yajun; CHENG Yafei; MA Yaqun

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Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (4) : 319-324.

ORIGINAL ARTICLES

Effect of functional near-infrared spectroscopy in pain assessment under general anesthesia

JIN Chenyan¹, GUO Hang², LI Qinghua¹, LI Yajun¹, CHENG Yafei¹, MA Yaqun^1,2

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Abstract

Objective To explore the effect of functional near-infrared spectroscopy (fNIRS) in pain assessment under general anesthesia. Methods This prospective study included 45 children aged 0-14 years who underwent hypospadias repair or cryptic penile correction in the Seventh Medical Center of PLA General Hospital from November 2021 to September 2022. They were divided into general anesthesia group (G group, n=30) and general anesthesia+dorsal penile nerve block group(N group, n=15) according to whether or not they underwent dorsal penile nerve block. Continuous wave functional near infrared spectroscopy imaging equipment was used to collect the blood oxygen parameters and heart rate of the left prefrontal brain tissue from 5 min before skin resection to 5 min after skin resection. The mean value and peak value of blood oxygen parameters and heart rate of the left prefrontal brain tissue before and after skin resection were compared. Results Compared with baseline before skin resection (T₁), the left prefrontal cortex of group G was activated after skin resection, the blood oxygen parameters of brain tissue all reached the peak within 3 s (T₂), and the mean concentration of oxygenated hemoglobin, deoxyhemoglobin, total hemoglobin and average heart rate increased significantly at T₂, with statistical significance (P<0.05). However, compared with baseline before skin resection (T₁), the left prefrontal cortex of group N was not significantly activated after resection, and there were no significant changes in the average oxygenated hemoglobin concentration, the average deoxyhemoglobin concentration, the average total hemoglobin concentration and the average heart rate at T₂, with no statistical significance. After G group receiving the stimulation of skin resection, compared with the time when the heart rate reached the peak, the blood oxygen parameter of the left prefrontal brain tissue reached the peak time earlier than the heart rate [(2.100±0.845)s], in which the Deoxy-Hb concentration [(1.723±0.783) s, P=0.041] and Total-Hb concentration [(1.763±0.770) s, P=0.028] had a statistically significant difference in the peak time. Conclusions fNIRScan be used to evaluate pain in children under general anesthesia. Compared with conventional physiological indicators, fNIRS is more sensitive and has great potential to optimize clinical pain assessment and management.

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pain / evaluate / blood oxygen parameters of brain tissue / children / general anesthesia / functional near-infrared spectroscopy

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JIN Chenyan, GUO Hang, LI Qinghua, LI Yajun, CHENG Yafei, MA Yaqun. Effect of functional near-infrared spectroscopy in pain assessment under general anesthesia[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(4): 319-324

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