Nosisepsiyonun Monitörizasyonu

Cerrahi sırasında oluşan doku hasarı ve enflamasyon ile indükle- nen nosisepsiyon, hastaya genel anestezi uygulamanın birincil ne- denidir. Genel anestezi sırasında, analjezikler otonomik ve soma- tik tepkileri, hipnotik ajanlar farkındalığı ve nöromüsküler bloker ajanlar da refleks hareketleri önler. Genel anestezinin etkilerinin dikkatle izlenmesi anesteziklerin gereğinden az veya fazla dozda verilmesinden kaçınmak ve dolayısıyla ilişkili komplikasyonları ve olumsuz etkileri önlemek için gereklidir. Genel olarak, opioidler gibi analjeziklerin intraoperatif uygulanmasına rehberlik etmek için hemodinamik parametreler kullanılmıştır, ancak hemodina- mik parametreler standardize edilmemiştir ve her zaman net bir değerlendirme sağlayamaz. Uygun bir nosisepsiyon ve anti-nosi- sepsiyon dengesi sağlamak ve analjezik uygulamasını yönlendir- mek için, anestezinin analjezi bileşenini objektif olarak izleyebile- cek tekniklere giderek artan bir ilgi vardır. Bu derlemenin amacı klinik pratikte giderek daha çok kullanılan nosisepsiyon izleme teknikleri hakkında bilgiler aktarmaktır.

Nociception Monitoring

Tissue damage and inflammation-induced nociception during surgery are the primary reasons for administering general anes- thesia to the patient. During general anesthesia, analgesics in- hibit autonomic and somatic responses, hypnotic agents prevent awareness, and neuromuscular blocking agents inhibit reflex movements. Careful monitoring of the effects of general anes- thesia is necessary to avoid over- or under-dosing of anesthetics and thus to prevent associated complications and adverse effects. In general, hemodynamic parameters have been used to guide the intraoperative administration of analgesics such as opioids, but hemodynamic parameters are not standardized and cannot always provide a clear assessment. There is growing interest in techniques that can objectively monitor the analgesic component of anesthesia to achieve an appropriate balance of nociception and anti-nociception and to guide analgesic administration. The purpose of this review is to provide information about no- ciception monitoring techniques, which are increasingly used in clinical practice.

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