Changes in the Nociception Level Index During Surgical Resection of Paragangliomas: A Case Report

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Abstract

Nociception is the detection of noxious stimulation by the nervous system. The PMD-200 monitor is a validated, emerging technology for intraoperative monitoring using the nociception level (NOL) index. We describe a pediatric case of an open resection of paraganglionic masses during which episodic increases in NOL index and blood pressure coincided with tumor manipulation, presumably due to a catecholamine surge. Since the patient was under stable and adequate analgesia, the increases in NOL index likely reflected the physiologic effects of tumor handling rather that the presence of a true noxious stimulus. Clinicians should consider this limitation when using this monitor.

Original languageEnglish (US)
Pages (from-to)e01542
JournalA&A practice
Volume15
Issue number11
DOIs
StatePublished - Nov 2 2021

ASJC Scopus subject areas

  • Medicine(all)

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