Accurately assessing pain levels of a patient is always a challenge, and when the person is unable to communicate to describe the pain they are in, the challenge becomes even greater. Medasense Biometrics, Ltd. recently announced they have developed a pain monitoring device, the PMD200. This new device was created to help physicians in assessing pain levels of an individual when the patient is unable to communicate. This will assist anesthesia teams in providing the correct amount of pain-relief medicine based on accurately assessing pain levels of the patient. This device is based on the NOL technology, which quantifies an individual’s psychological response to pain. The PMD200 is a very easy to use system, which includes a finger probe that records psychological signals from four different sensors. The device also records dozens of pain-related psychological parameters. The data is then analyzed and converted into the Nociception Level index. In this index, 0 = no pain and 100 = extreme pain. This system will allow physicians to better manage pain treatments and help them avoid using too much or too little pain medicine. Too much pain medicine during a procedure can cause a patient to suffer from nausea, vomiting, respiratory depression, constipation, and hyperalgesia once they regain consciousness. Professor Albert Dahan, MD. PhD. from the Department of Anaesthesiology at Leiden University Medical Center in the Netherlands said, “We have been studying the PMD device for a number of years now, and I believe that the NOL index may allow for more balanced anesthesia, as for the first time we are able to titrate analgesic medication to patients’ needs. In the upcoming weeks, the LUMC will be adding PMD200 devices into the operating rooms. In the future, I hope to see the NOL index integrated into other monitors as it provides significant decision support information and can potentially positively impact patient outcomes.” The device is currently being distributed throughout Europe for use in operating rooms and in critical care units. The company also hopes to broaden the use of the NOL index and is currently researching other forms of pain such as chronic back pain. This device is a breakthrough in accurately assessing pain levels of a patient and can be a great asset to anesthesia teams in the future.
The thought of heading to the doctor for a procedure that requires local anesthesia probably doesn’t seem like that big of a deal. However, imagine if you were going to feel everything that was happening during the procedure. Well for some, this horrible nightmare is a reality. In very rare cases, some individuals have a resistance to local anesthesia, and no matter the amount received, they can still feel pain. In a report from the BBC, a woman named Lori Lemon, discusses how since she was young she has always had to go to the dentist and other doctors expecting to endure pain. Even after crying out during dental procedures, doctors never took Lori seriously. She describes a visit to the dentist as a young child when her condition first became apparent, “They started working on me and I, being obedient, I just raised my hand and let ’em know, ‘I can feel this’,” she says. Another injection still proved that she had a resistance to local anesthesia. “Finally I just kind of screamed and was in tears the whole time.” When she recently visited the Mayo Clinic in Jacksonville for a procedure to remove a lipoma from her elbow, an anesthesiologist noticed that none of their methods were working and knew something had to be wrong. Dr. Steven Clendenen, the anesthesiologist at the clinic, said “The nerves were flooded with local anaesthetic and at the time it didn’t work.” Clendenen decided to research this issue further and found that while there were other cases of this same problem, there was hardly any answers as to why patients had a resistance to local anesthesia. After finding out Lemon’s mother and maternal half-sister also suffer from a similar type of resistance to local anesthesia, he decided to do a genetic study on the family. Doctors discovered a genetic defect which was directly related to a specific sodium channel in the body, sodium 1.5. “We looked at the genetics of that and went, ‘wow’ – [her mother] had the same gene defect,” explains Clendenen. This genetic mutation is significant due to the theory that local anesthetics are successful due to the disruption of sodium channels. Since sodium 1.5 channels have mostly been studied in heart tissue, not the peripheral nerves where local anaesthetic is applied, there is still a lot of research that needs to be done. “This is really important to get that out there,” said Clendenen. “People don’t believe [these patients] and it’s very frustrating. Even some of my colleagues that I’ve talked to say, ‘I don’t believe it’.” For patients like Lori Lemon, however, this has put light on the issue and gives them some relief knowing there is work being done to figure out this problem. If you or a loved one is preparing for a procedure, click here to visit our anesthesia information page to learn more.
It is pretty fair to say that no one really enjoys getting a cavity filled or going under anesthesia because of a painful surgery, it’s just something we have to do. Although it isn’t fun for anyone, redheads may dread a trip to the dentist’s office a bit more than the average person, and for good reason. Over the years, many have said that a patient’s natural hair color may have an impact on anesthesia efforts. But do redheads really require more anesthesia? Recent studies have been done that show people with naturally red hair often require a higher dosage of anesthesia, and are sometimes resistant to pain blockers, such as novocaine, than their brunette or blonde counterparts. Making up only 1-2% of the population worldwide, the genetics of a redhead are what makes them such a rarity. Researchers believe a mutation of the gene that causes people to have red hair and fair skin, also has an effect on a person’s sensitivity to pain. The Mc1R gene, which affects hair color, produces melanin in people with blond, black, or brown hair, but a mutation causes it to produce pheomelanin in redheads. This gene is a part of a family of receptors in the brain that include pain receptors, which may be why it affects a redheads tolerance of pain. Dr. Daniel I. Sessler, an anesthesiologist and chairman of the department of outcomes research at the Cleveland Clinic, said he started studying hair color after hearing many colleagues discuss redheads needing more anesthesia than patients with different hair colors. “The reason we studied redheads in the beginning, it was essentially an urban legend in the anesthesia community saying redheads were difficult to anesthetize,” Dr. Sessler said. “This was so intriguing we went ahead and studied it. Redheads really do require more anesthesia, and by a clinically important amount.” Researchers believe patients with red hair require about 20% more general anesthesia than the average person, which proves that redheads being harder to anesthetize was not just a myth in the medical community. Another study in 2005, proved that redheads are more resistant to the effects of local anesthesia, such as the numbing drugs that are often used by dentists. It is possible that people with dark skin, eyes, and hair may produce more melanin than normal and in turn will also require more anesthesia. So the next time you hear your redheaded friend complaining about a routine trip to the dentist, you’ll know why!
It is no surprise that at a time where technology is rapidly changing and advancing, machines are sometimes being used to replace humans to perform certain jobs. Some believe that machines can perform tasks and make decisions more efficiently than humans. The world of healthcare and anesthesia service is not immune to these types of practices.
“That’s like comparing apples to oranges.” How many times have you heard or even used this expression? In medicine, no two patients, no two hospitals, not two…well, anything is the same. So why do so many healthcare facilities still use the excuse that there isn’t any difference between anesthesia management solutions organizations?
Patient satisfaction is a new competitive advantage for anesthesia services. The holiday season also brings a silent pressure to find the perfect gift for all of the people on your shopping list. Whether it is the latest and greatest technology or, as in a scene from National Lampoon’s Christmas Vacation, the jelly of the month club, everyone is looking for, “the gift that keeps giving the whole year.” For Steel City Anesthesia, the gifts we provide our facilities such as costs savings, efficient operating procedures and expert anesthesia services, are presents we deliver every day. However, patient satisfaction is an integral part to quality management and is the perfect “gift” from any anesthesia partners.
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