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  Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain

Lichtner, G., Auksztulewicz, R., Kirilina, E., Velten, H., Mavrodis, D., Scheel, M., et al. (2018). Effects of propofol anesthesia on the processing of noxious stimuli in the spinal cord and the brain. NeuroImage, 172, 642-653. doi:10.1016/j.neuroimage.2018.02.003.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0000-B92D-E Version Permalink: http://hdl.handle.net/21.11116/0000-0003-9AD2-2
Genre: Journal Article

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 Creators:
Lichtner, Gregor1, Author
Auksztulewicz, Ryszard2, Author
Kirilina, Evgeniya3, 4, Author              
Velten, Helena1, Author
Mavrodis, Dionysios1, Author
Scheel, Michael5, Author
Blankenburg, Felix3, Author
von Dincklage, Falk1, Author
Affiliations:
1Charité University Medicine Berlin, Germany, ou_persistent22              
2Department of Biomedical Sciences, City University of Hong Kong, China, ou_persistent22              
3Neurocomputation and Neuroimaging Unit, FU Berlin, Germany, ou_persistent22              
4Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              
5Berlin Institute of Health (BIH), Germany, ou_persistent22              

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Free keywords: Nociception; General anesthesia; Propofol; Unconsciousness; Pain; Nociceptive flexion reflex
 Abstract: Drug-induced unconsciousness is an essential component of general anesthesia, commonly attributed to attenuation of higher-order processing of external stimuli and a resulting loss of information integration capabilities of the brain. In this study, we investigated how the hypnotic drug propofol at doses comparable to those in clinical practice influences the processing of somatosensory stimuli in the spinal cord and in primary and higher-order cortices. Using nociceptive reflexes, somatosensory evoked potentials and functional magnet resonance imaging (fMRI), we found that propofol abolishes the processing of innocuous and moderate noxious stimuli at low to medium concentration levels, but that intense noxious stimuli evoked spinal and cerebral responses even during deep propofol anesthesia that caused profound electroencephalogram (EEG) burst suppression. While nociceptive reflexes and somatosensory potentials were affected only in a minor way by further increasing doses of propofol after the loss of consciousness, fMRI showed that increasing propofol concentration abolished processing of intense noxious stimuli in the insula and secondary somatosensory cortex and vastly increased processing in the frontal cortex. As the fMRI functional connectivity showed congruent changes with increasing doses of propofol – namely the temporal brain areas decreasing their connectivity with the bilateral pre-/postcentral gyri and the supplementary motor area, while connectivity of the latter with frontal areas is increased – we conclude that the changes in processing of noxious stimuli during propofol anesthesia might be related to changes in functional connectivity.

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Language(s): eng - English
 Dates: 2017-09-272018-02-022018-02-052018-05-15
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1016/j.neuroimage.2018.02.003
PMID: 29421324
Other: Epub 2018
 Degree: -

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Project name : -
Grant ID : DI1579/4-1
Funding program : -
Funding organization : German Research Foundation (DFG)

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Title: NeuroImage
Source Genre: Journal
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Publ. Info: Orlando, FL : Academic Press
Pages: - Volume / Issue: 172 Sequence Number: - Start / End Page: 642 - 653 Identifier: ISSN: 1053-8119
CoNE: https://pure.mpg.de/cone/journals/resource/954922650166