# Perioperative Measures of Nociception using NIRS

> **NIH NIH R01** · BOSTON CHILDREN'S HOSPITAL · 2020 · $398,250

## Abstract

ABSTRACT
Surgery is a common process – with some 43 million individuals undergoing surgery in the United States every
year. Depending on their premorbid and intraoperative processes, Individuals are vulnerable to acute
postoperative pain and more importantly in some 30% to chronic neuropathic pain that contributes to
significant morbidity. While general anesthesia provides a state of unconsciousness, there are no objective
measures of evoked or ongoing pain (i.e., analgesia) while under anesthesia. The lack of analgesic control
while under anesthesia may induce a response in the brain called central sensitization that is the harbinger of
two main deleterious outcomes: (1) increased pain and use of opioids in the postoperative period, and (2) the
initiation of a chronic neuropathic pain process (that may also be driven by the nerve damage from the surgical
incisions – peripheral sensitization). In this proposal we will introduce a novel mechanistic approach to the
assessment of nociceptive drive (both evoked pain and ongoing pain) in the perioperative period (i.e., during
surgery and in the postoperative period). We will use functional Near-Infrared Spectroscopy (fNIRS) to define
evoked pain and ongoing pain (i.e., an objective, quantitative assessment of analgesia in a surgical
environment). The combination will allow us to measure the Nociceptive Load during surgery. We hypothesize
that there is a correlation of the pain load and the postoperative course as measured by postoperative pain
levels, postoperative analgesic use. In order to do this we have 2 Specific Aims: (1) fNIRS Measures of
Opioid Blockade of Nociceptive Signals on Pain Load under Anesthesia; and (2) Define fNIRS Differences in
Pain Load (Evoked and Ongoing Pain) in the Perioperative (surgery and post surgery) in patients undergoing
knee arthroscopy who have inhalational anesthesia alone vs. inhalational anesthesia + regional blockade. We
have the necessary team that has worked together for many years (NIRS physicists, neurobiologists, pain
specialists, anesthesiologists and psychologist), equipment, publications, preliminary data and hospital support
to successfully carry out the proposed work. The successful completion of this research will provide a basis for
future studies that may provide: (1) Objective Measurement of Analgesic Depth and Pain Load during surgery
utilizing fNIRS; (2) Relative significance of continuous and repeated noxious events on pain load and clinical
outcomes (2) Objective Measurement of different anesthetics on Pain Load.

## Key facts

- **NIH application ID:** 9981820
- **Project number:** 5R01GM122405-04
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Barry David Kussman
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $398,250
- **Award type:** 5
- **Project period:** 2017-09-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9981820

## Citation

> US National Institutes of Health, RePORTER application 9981820, Perioperative Measures of Nociception using NIRS (5R01GM122405-04). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/9981820. Licensed CC0.

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