Can pain under anesthesia be measured? Pain-related brain function using functional near-infrared spectroscopy during knee surgery

Keerthana D. Karunakaran; Ke Peng; Stephen Green; Christine B. Sieberg; Arielle Mizrahi-Arnaud; Andrea Gomez-Morad; David Zurakowski; Lyle Micheli; Barry Kussman; David Borsook

doi:10.1117/1.NPh.10.2.025014

9 June 2023 Can pain under anesthesia be measured? Pain-related brain function using functional near-infrared spectroscopy during knee surgery

Keerthana D. Karunakaran, Ke Peng, Stephen Green, Christine B. Sieberg, Arielle Mizrahi-Arnaud, Andrea Gomez-Morad, David Zurakowski, Lyle Micheli, Barry Kussman, David Borsook

Author Affiliations +

Neurophotonics, Vol. 10, Issue 2, 025014 (June 2023). https://doi.org/10.1117/1.NPh.10.2.025014

Abstract

Significance

Quantitative measurement of perisurgical brain function may provide insights into the processes contributing to acute and chronic postsurgical pain.

Aim

We evaluate the hemodynamic changes in the prefrontal cortex (medial frontopolar cortex/mFPC and lateral prefrontal cortex) and the primary somatosensory cortex/S1 using functional near-infrared spectroscopy (fNIRS) in 18 patients (18.2 ± 3.3 years, 11 females) undergoing knee arthroscopy.

Approach

We examined the (a) hemodynamic response to surgery and (b) the relationship between surgery-modulated cortical connectivity (using beta-series correlation) and acute postoperative pain levels using Pearson’s r correlation with 10,000 permutations.

Results

We show a functional dissociation between mFPC and S1 in response to surgery, where mFPC deactivates, and S1 activates following a procedure. Furthermore, the connectivity between (a) left mFPC and right S1 (original r = − 0.683, p_permutation = 0.001), (b) right mFPC and right S1 (original r = − 0.633, p_permutation = 0.002), and (c) left mFPC and right S1 (original r = − 0.695, p_permutation = 0.0002) during surgery were negatively associated with acute postoperative pain levels.

Conclusions

Our findings suggest that greater functional dissociation between mFPC and S1 is likely the result of inadequately controlled nociceptive barrage during surgery leading to more significant postoperative pain. It also supports the utility of fNIRS during the perioperative state for pain monitoring and patient risk assessment for chronic pain.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Keerthana D. Karunakaran, Ke Peng, Stephen Green, Christine B. Sieberg, Arielle Mizrahi-Arnaud, Andrea Gomez-Morad, David Zurakowski, Lyle Micheli, Barry Kussman, and David Borsook "Can pain under anesthesia be measured? Pain-related brain function using functional near-infrared spectroscopy during knee surgery," Neurophotonics 10(2), 025014 (9 June 2023). https://doi.org/10.1117/1.NPh.10.2.025014

Received: 7 September 2022; Accepted: 21 April 2023; Published: 9 June 2023

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