# Developing Active Stimulation and Monitoring Technologies to Optimize Pain and Nociception Management During Regional Anesthesia, General Anesthesia, and Post-Operative Care

> **NIH NIH R42** · PASCALL SYSTEMS, INCORPORATED · 2024 · $1,208,662

## Abstract

Project Summary
Surgery and acute post-operative pain are major contributors to persistent pain, chronic pain, and opioid
dependence. Currently, there are no products on the market in the United States that can be used to monitor
surgical nociception. Existing products use indicators that are susceptible to intraoperative influences such as
blood loss, anesthetic drugs and antihypertensives. This leaves anesthesiologists to guess whether or not the
analgesic therapies they are providing will be effective at managing intra-operative nociception and subsequent
post-operative pain. A significant fraction of surgeries also rely on regional anesthesia techniques, and, these
techniques are not foolproof, and may fail during surgery, leading to potentially uncontrolled postoperative pain
that is apparent only when the patient recovers consciousness after surgery in intense pain. As it stands,
anesthesiologists have no way to directly assess the ongoing efficacy of their regional blocks, leading to
unreliable nociception and pain management. Therefore, improved methods to monitor surgical nociception are
clearly needed. This project proposes to develop new technology that makes it possible for the first time to use
event-related potentials (ERPs) to actively assess pain and analgesia during general and regional anesthesia.
ERPs are generated by painful stimuli and can be measured at the scalp by averaging waveforms from repeated
stimuli generated by a variety of methods including electrical stimulation. ERPs are challenging if not impossible
to use for anesthesia monitoring because they are very small, between ~1 to 10 microvolts, and are
overshadowed by background electroencephalogram oscillations that are 10- to 100-fold larger in amplitude
during general anesthesia or sedation. Recently, we developed a novel technology for processing ERPs that
increases their precision ~150-fold even in the presence of orders-of-magnitude larger background oscillations.
Using this knowledge, we propose to develop this technology for commercial use in a “Fast-Track” STTR project.

## Key facts

- **NIH application ID:** 11160369
- **Project number:** 4R42NS129395-02
- **Recipient organization:** PASCALL SYSTEMS, INCORPORATED
- **Principal Investigator:** Tuan Le Mau
- **Activity code:** R42 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,208,662
- **Award type:** 4N
- **Project period:** 2023-09-19 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11160369

## Citation

> US National Institutes of Health, RePORTER application 11160369, Developing Active Stimulation and Monitoring Technologies to Optimize Pain and Nociception Management During Regional Anesthesia, General Anesthesia, and Post-Operative Care (4R42NS129395-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/11160369. Licensed CC0.

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