Publications of Aline DEFRESNE
Bookmark and Share    
See detailNociception et antinociception en 2020
DEFRESNE, Aline ULiege

Scientific conference (2020, May 07)

Detailed reference viewed: 25 (3 ULiège)
See detailAjustement individuel de l'antinociception au cours de l'anesthésie générale
DEFRESNE, Aline ULiege

Conference (2019, October 08)

Detailed reference viewed: 21 (1 ULiège)
Full Text
See detailContribution à une meilleure gestion de la nociception peropératoire
DEFRESNE, Aline ULiege

Doctoral thesis (2019)

Detailed reference viewed: 20 (2 ULiège)
Full Text
See detailGeneral Anesthesia: A Probe to Explore Consciousness
BONHOMME, Vincent ULiege; STAQUET, Cécile ULiege; Montupil, Javier ULiege et al

in Frontiers in Systems Neuroscience (2019)

Detailed reference viewed: 103 (31 ULiège)
See detailA simple case of torticollis leads to the diagnosis of an infantile desmoplasticf astrocytoma
Gillis, Nathalie; Bex, Alix; Bex, Vincent et al

Conference (2019, May 24)

Detailed reference viewed: 20 (1 ULiège)
Full Text
See detailThe Raw and Processed Electroencephalogram as a Monitoring and Diagnostic Tool.
Montupil, Javier ULiege; DEFRESNE, Aline ULiege; BONHOMME, Vincent ULiege

in Journal of cardiothoracic and vascular anesthesia (2019), 33 Suppl 1

In this narrative review, different aspects of electroencephalogram (EEG) monitoring during anesthesia are approached, with a special focus on cardiothoracic and vascular anesthesia, from the basic ... [more ▼]

In this narrative review, different aspects of electroencephalogram (EEG) monitoring during anesthesia are approached, with a special focus on cardiothoracic and vascular anesthesia, from the basic principles to more sophisticated diagnosis and monitoring utilities. The available processed EEG-derived indexes of the depth of the hypnotic component of anesthesia have well-defined limitations and usefulness. They prevent intraoperative awareness with recall in specific patient populations and under a specific anesthetic regimen. They prevent intraoperative overdose, and they shorten recovery times. They also help to avoid lengthy intraoperative periods of suppression activity, which are known to be deleterious in terms of outcome. Other than those available indexes, the huge amount of information contained in the EEG currently is being used only partially. Several other areas of interest regarding EEG during anesthesia have emerged in terms of anesthesia mechanisms elucidation, nociception monitoring, and diagnosis or prevention of brain insults. [less ▲]

Detailed reference viewed: 52 (2 ULiège)
Full Text
See detailVon Willebrand disease
BONHOMME, Vincent ULiege; DEFRESNE, Aline ULiege; MAQUOI, Isabelle ULiege et al

in Anästhesiologie und Intensivmedizin (2019), 33(3), 463-9

Detailed reference viewed: 23 (2 ULiège)
Full Text
See detailTwo different methods to assess sympathetic tone during general anesthesia lead to different findings.
DEFRESNE, Aline ULiege; Harrison, Michael; Clement, Francois et al

in Journal of Clinical Monitoring and Computing (2019)

Noxious stimulation influences the autonomic nervous system activity. Sympathetic tone monitoring is currently used to assess the adequacy of the balance between nociception and anti-nociception during ... [more ▼]

Noxious stimulation influences the autonomic nervous system activity. Sympathetic tone monitoring is currently used to assess the adequacy of the balance between nociception and anti-nociception during general anesthesia. The Surgical Plethysmographic Index (SPI) and the EBMi software (Custos(c)) are commercial devices that use different algorithms to measure it. We aimed at determining whether those devices provide similar information during routine surgical procedures under general anesthesia. Data acquired during a previously published study in patients undergoing surgery under general anesthesia were retrospectively analyzed and passed through the EBMi software. The occurrence of EBMi alarms of increased sympathetic tone was compared to the occurrence of SPI values >/= 60, a commonly recommended intraoperative SPI threshold. Trends in classical parameters of sympathetic tone during the 5 min preceding a SPI >/= 60, namely blood pressure, heart rate, and plethysmographic pulse amplitude were assessed. SPI >/= 60 episodes (n = 307) were more frequent than EBMi alerts (n = 240). Approximately 70% of EBMi alerts occurred during periods where the SPI was below 60. Among all episodes of SPI >/= 60, absence of any EBMi alerts was much more frequent than the inverse. A majority, but not all SPI >/= 60 episodes were consistently preceded by an increase in heart rate and/or a decrease in pulse amplitude. Blood pressure did not significantly change before SPI >/= 60. Longer SPI >/= 60 episodes were associated with lower anti-nociception anesthetic regimen. Different methods of sympathetic tone assessment during general anesthesia provide conflicting information. Prospective studies should be undertaken to clarify the clinical indications of both techniques. [less ▲]

Detailed reference viewed: 40 (7 ULiège)
Full Text
See detailNeuromonitoring
DEFRESNE, Aline ULiege; BONHOMME, Vincent ULiege

in Prabhakar, Hemanshu (Ed.) Paediatric Neuroanaesthesia (2018)

Detailed reference viewed: 63 (13 ULiège)
Full Text
See detailStandardised noxious stimulation-guided individual adjustment of remifentanil target-controlled infusion to prevent haemodynamic responses to laryngoscopy and surgical incision: A randomised controlled trial.
DEFRESNE, Aline ULiege; Barvais, Luc; Clement, Francois et al

in European Journal of Anaesthesiology (2018), 35(3), 173-183

BACKGROUND: The surgical plethysmographic index (SPI) is one of the available indexes of the nociception-antinociception (NAN) balance. Individually adjusting the NAN balance to prevent somatic responses ... [more ▼]

BACKGROUND: The surgical plethysmographic index (SPI) is one of the available indexes of the nociception-antinociception (NAN) balance. Individually adjusting the NAN balance to prevent somatic responses to noxious stimulation remains a challenge. OBJECTIVES: To assess whether guiding remifentanil administration according to the SPI response to a calibrated noxious stimulus (NANCAL) can blunt the haemodynamic response to tracheal intubation and surgical incision. DESIGN: Randomised multicentre study. SETTING: Two Belgian university hospitals from January 2014 to April 2015. PATIENTS: After ethic review board approval and informed consent, 48 American Society of Anesthesiologists I or II adult patients scheduled for surgery under general anaesthesia were enrolled. INTERVENTIONS: Patients were randomly assigned to a SPI group, where remifentanil effect-site concentration was adjusted according to NANCAL, or a control group, where it was fixed at 4 ng ml. Propofol concentration was always adjusted to maintain the bispectral index close to 40. NANCAL consisted of a 100 Hz, 60 mA electrical tetanic stimulation during 30 s at the wrist before tracheal intubation and before surgical incision. MAIN OUTCOME MEASURES: The primary endpoint was the efficacy of the NANCAL-guided remifentanil administration to prevent the haemodynamic response to tracheal intubation and surgical incision. The secondary aim was to compare the ability of SPI, analgesia nociception index, pupil diameter and mean arterial pressure response to NANCAL to predict the haemodynamic response to tracheal intubation and surgical incision. RESULTS: Our SPI response to NANCAL-based correcting scheme for remifentanil administration was not superior to a fixed remifentanil concentration at blunting the haemodynamic response to tracheal intubation or surgical incision. Among all tested NAN balance indices, only mean arterial pressure had significant predictive ability with regard to the haemodynamic response to surgical incision. CONCLUSION: Further research is needed to define the best NANCAL stimulus and the best remifentanil correcting scheme to help individualised tailoring of antinociception for each specific subpopulation of surgical patients. TRIAL REGISTRATION: Clinicaltrials.gov NCT: 02884310; https://clinicaltrials.gov/ct2/show/NCT02884310. [less ▲]

Detailed reference viewed: 17 (2 ULiège)
Full Text
See detailElectroencephalography-based monitors
TRAN, Gabriel ULiege; DEFRESNE, Aline ULiege; FRANSSEN, Colette ULiege et al

in Prabhakar, Hemanshu (Ed.) Neuromonitoring techniques (2017)

Detailed reference viewed: 46 (11 ULiège)
Full Text
See detailMultimodal monitoring
DEFRESNE, Aline ULiege; BONHOMME, Vincent ULiege

in Prabhakar, Hemanshu (Ed.) Essentials of neuroanesthesia (2017)

Detailed reference viewed: 23 (5 ULiège)
Full Text
See detailFrontal alpha-delta EEG does not preclude volitional response during anaesthesia: Prospective cohort study of the isolated forearm technique
Gaskell, A. L.; Hight, D. F.; Winders, J. et al

in British Journal of Anaesthesia (2017), 119(4), 664-673

Background The isolated forearm test (IFT) is the gold standard test of connected consciousness (awareness of the environment) during anaesthesia. The frontal alpha-delta EEG pattern (seen in slow wave ... [more ▼]

Background The isolated forearm test (IFT) is the gold standard test of connected consciousness (awareness of the environment) during anaesthesia. The frontal alpha-delta EEG pattern (seen in slow wave sleep) is widely held to indicate anaesthetic-induced unconsciousness. A priori we proposed that one responder with the frontal alpha-delta EEG pattern would falsify this concept. Methods Frontal EEG was recorded in a subset of patients from three centres participating in an international multicentre study of IFT responsiveness following tracheal intubation. Raw EEG waveforms were analysed for power-frequency spectra, depth-of-anaesthesia indices, permutation entropy, slow wave activity saturation and alpha-delta amplitude-phase coupling. Results Volitional responses to verbal command occurred in six out of 90 patients. Three responses occurred immediately following intubation in patients (from Sites 1 and 2) exhibiting an alpha-delta dominant (delta power >20 dB, alpha power >10 dB) EEG pattern. The power-frequency spectra obtained during these responses were similar to those of non-responders (P>0.05) at those sites. A further three responses occurred in (Site 3) patients not exhibiting the classic alpha-delta EEG pattern; these responses occurred later relative to intubation, and in patients had been co-administered ketamine and less volatile anaesthetic compared with Site 1 and 2 patients. None of the derived depth-of-anaesthesia indices could robustly discrimate IFT responders and non-responders. Conclusions Connected consciousness can occur in the presence of the frontal alpha-delta EEG pattern during anaesthesia. Frontal EEG parameters do not readily discriminate volitional responsiveness (a marker of connected consciousness) and unresponsiveness during anaesthesia. Clinical trial registration NCT02248623 © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. [less ▲]

Detailed reference viewed: 20 (3 ULiège)
Full Text
See detailIncidence of Connected Consciousness after Tracheal Intubation: A Prospective, International, Multicenter Cohort Study of the Isolated Forearm Technique
Sanders, R. D.; Gaskell, A.; Raz, A. et al

in Anesthesiology (2017), 126(2), 214-222

Background: The isolated forearm technique allows assessment of consciousness of the external world (connected consciousness) through a verbal command to move the hand (of a tourniquet-isolated arm ... [more ▼]

Background: The isolated forearm technique allows assessment of consciousness of the external world (connected consciousness) through a verbal command to move the hand (of a tourniquet-isolated arm) during intended general anesthesia. Previous isolated forearm technique data suggest that the incidence of connected consciousness may approach 37% after a noxious stimulus. The authors conducted an international, multicenter, pragmatic study to establish the incidence of isolated forearm technique responsiveness after intubation in routine practice. Methods: Two hundred sixty adult patients were recruited at six sites into a prospective cohort study of the isolated forearm technique after intubation. Demographic, anesthetic, and intubation data, plus postoperative questionnaires, were collected. Univariate statistics, followed by bivariate logistic regression models for age plus variable, were conducted. Results: The incidence of isolated forearm technique responsiveness after intubation was 4.6% (12/260); 5 of 12 responders reported pain through a second hand squeeze. Responders were younger than nonresponders (39 ± 17 vs. 51 ± 16 yr old; P = 0.01) with more frequent signs of sympathetic activation (50% vs. 2.4%; P = 0.03). No participant had explicit recall of intraoperative events when questioned after surgery (n = 253). Across groups, depth of anesthesia monitoring values showed a wide range; however, values were higher for responders before (54 ± 20 vs. 42 ± 14; P = 0.02) and after (52 ± 16 vs. 43 ± 16; P = 0.02) intubation. In patients not receiving total intravenous anesthesia, exposure to volatile anesthetics before intubation reduced the odds of responding (odds ratio, 0.2 [0.1 to 0.8]; P = 0.02) after adjustment for age. Conclusions: Intraoperative connected consciousness occurred frequently, although the rate is up to 10-times lower than anticipated. This should be considered a conservative estimate of intraoperative connected consciousness. [less ▲]

Detailed reference viewed: 18 (5 ULiège)
Full Text
See detailClinical pertinence and diagnostic accuracy of an evidence-based monitoring system: Custos.
DEFRESNE, Aline ULiege; Harrison, Michael; Bonhomme, Vincent

in European journal of anaesthesiology (2016), 33(8), 590-2

Detailed reference viewed: 17 (0 ULiège)
Full Text
See detailInfluence des agents anesthésiques sur la circulation et l’autorégulation cérébrale
DEFRESNE, Aline ULiege

Conference (2015, November 26)

Detailed reference viewed: 25 (9 ULiège)
See detailEvaluation of the accuracy of the EBMi software to detect hypovolemia as defined by Delta-Down
Jadot, Laurent; DEFRESNE, Aline ULiege; Harrisson, Michael et al

Conference (2014, November 08)

Detailed reference viewed: 22 (0 ULiège)
Full Text
See detailRecruitment of lung volume during surgery neither affects the postoperative spirometry nor the risk of hypoxaemia after laparoscopic gastric bypass in morbidly obese patients: a randomized controlled study.
DEFRESNE, Aline ULiege; HANS, Grégory ULiege; GOFFIN, Pierre ULiege et al

in British Journal of Anaesthesia (2014), 113(3), 501-7

BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation ... [more ▼]

BACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation. Whether these benefits persist after operation remains unknown. We tested the hypothesis that intraoperative RMs associated with PEEP improve postoperative spirometry including FRC and reduce the incidence of postoperative hypoxaemia in morbidly obese (MO) patients undergoing laparoscopic gastric bypass. METHODS: After IRB approval and informed consent, 50 MO patients undergoing laparoscopic gastric bypass under volume-controlled ventilation (tidal volume 6 ml kg(-1) of IBW) were randomly ventilated with either 10 cm H(2)O PEEP or with 10 cm H(2)O PEEP and one RM carried out after induction of pneumoperitoneum, and another after exsufflation. Anaesthesia and analgesia were standardized. Spirometry was assessed before operation and 24 h after surgery. Postoperative oxygenation and the apnoea-hypopnoea index (AHI) were recorded during the first postoperative night. RESULTS: Age, BMI, and STOP BANG score were similar in both groups. FRC decrease after surgery was minimal [0.15 (0.14) litre in control and 0.38 (0.19) litre in the RM group] and similar between the groups (P=0.35). FVC, FEV1, mean [Formula: see text], percentage of time spent with [Formula: see text] below 90%, and AHI did not differ significantly between the groups. CONCLUSIONS: This study demonstrates that when added to a protective mechanical ventilation combining low tidal volume and high PEEP, two RMs do not improve postoperative lung function including FRC, arterial oxygenation, and the incidence of obstructive apnoea in MO patients after laparoscopic upper abdominal surgery. CLINICAL TRIAL REGISTRATION: EudraCT 2011-000999-33. [less ▲]

Detailed reference viewed: 52 (9 ULiège)