Monitoring the stress response during general anaesthesia

The major objectives of anaesthetists in the operating theatre are to maintain the hypnosis, the relaxation, the analgesia, and the vital functions during the operation. The aim of this paper is to present an overview of new developments regarding monitoring and control of stress response during general anaesthesia. The applicability of the main parameters to monitor the adequacy of analgesia online will be discussed. Different models based on pharmacokinetic and pharmacodynamic effects in particular the opioid remifentanil and the hypnotic propofol were developed. The response of these anaesthetics on heart rate, different parameters of the heart rate variability and the bispectral index during induction of general anaesthesia were studied. Starting from these models, control strategies in analgesia have been discussed. The developed environment for the assistant system for anaesthesia at the University of Rostock is presented.