Developing novel technologies to monitor nociception and opioid administration during surgery and general anesthesia in order to minimize post-operative opioid requirements

PROJECT SUMMARY
In light of the opioid crises, minimizing postoperative pain and postoperative opioid requirements to reduce
chronic opioid dependency among surgical patients have become major concerns for surgeons and
anesthesiologists. Effective intraoperative nociception control can mitigate these concerns. Unfortunately,
existing nociceptive monitoring tools use indicators that are inherently susceptible to intraoperative influences.
Monitoring these indicators often lead to suboptimal intraoperative opioid administration, since there is no way
to account for whether these measures are being influenced by nociception or numerous other intraoperative
factors such as blood loss, anesthetic drugs and antihypertensives. Therefore, improved methods to monitor
surgical nociception are clearly needed. In short, currently available nociceptive monitors measure unreliable
indicators and predispose surgical patients to suboptimal opioid dosing administration leading to ineffective
intraoperative control. The consequences for surgical patients can be significant, since increased postoperative
pain and opioid requirements is associated with increased incidence of opioid dependency. This project
proposes to develop a state-of-the-art sensors, algorithms, and prospective observational data to construct an
integrated measure of nociceptive control based on autonomic (EDA) and neurophysiologic markers of arousal
and nociception (EEG-based arousal and opioid signatures).PROJECT NARRATIVE
Effective nociception monitoring and control during surgery can minimize post-operative pain and reduce post-
operative opioid requirements among surgical patients, thereby decreasing their chances of opioid dependency,
but existing nociception monitoring tools are imperfect in that they monitor markers such as heart rate and blood
pressure that are inherently influenced by various intraoperative factors. This leads to suboptimal opioid
administration for nociception control. This project proposes to develop a novel surgical nociception monitor that
comprises of an integrated measure of nociceptive control based on neurophysiological (EEG) and autonomic
(EDA) markers of arousal and nociception that aren’t susceptible to intraoperative factors.