Nociceptive responses to short tetanic stimulation during posttetanic count monitoring in surgical patients: a retrospective cohort study
Authors' conclusion
Short tetanic stimulation during posttetanic count monitoring induced nociceptive responses as evidenced by changes in hemodynamics and EEG band powers.
Study context
- Population
- Adults undergoing ophthalmic or otolaryngologic surgery with quantitative NMB monitoring, October 2022 to October 2023
- Participants
- 732 adults
- Exposure
- Before vs after short tetanic stimulation during posttetanic count monitoring (responders)
- Outcome
- Nociceptive response (responder: ≥20% increase in heart rate after 5 sec of tetanic stimulation)
Main finding
As reported in the abstract
Responders
Responders
11%
78/732
Heart rate in responders, mean (95% CI): 67 (64 to 70) to 88 (85 to 92) min-1; P < 0.001
+33%
SBP in responders, mean (95% CI): 107 (102 to 112) to 119 (114 to 124) mm Hg; P < 0.001
+12%
EEG alpha band power loss in responders, mean (95% CI): −5.9 dB [−6.4 to −5.4] to −6.6 dB [−7.1 to −6.0]; P = 0.003
−14%
Observational data: associations, not effects.
Further findings
Risk factors for nociceptive response (multivariable logistic regression)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Remifentanil effect-site concentrationLower concentrations associated with nociceptive changes | 0.90 (0.85–0.95) | P = 0.001 | |
| Body weightLower body weight associated with nociceptive changes | 0.74 (0.52–0.95) | P = 0.04 | |
| 0.512Odds ratio (log scale) |
Original publication
Nociceptive responses to short tetanic stimulation during posttetanic count monitoring in surgical patients: a retrospective cohort study. Can J Anaesth. Published 12 February 2026. doi:10.
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