Abstract
Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes modulate autonomic output to mitigate excessive fluctuations in arterial blood pressure and to maintain intravascular volume, increasing evidence suggests that baroreflex pathways also project to key regions of the central nervous system that regulate somatosensory, somatomotor, and central nervous system arousal. In addition to maintaining autonomic homeostasis, baroreceptor activity modulates the perception of pain, as well as neuroimmune, neuroendocrine, and cognitive responses to physical and psychologic stressors. This review summarizes the role that baroreceptor pathways play in modulating acute and chronic pain perception. The contribution of baroreceptor function to postoperative outcomes is also presented. Finally, methods that enhance baroreceptor function, which hold promise in improving postoperative and pain management outcomes, are presented.
Original language | English |
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Pages (from-to) | 634-650 |
Number of pages | 17 |
Journal | Anesthesiology |
Volume | 130 |
Issue number | 4 |
DOIs | |
Publication status | Published - 1 Apr 2019 |
Bibliographical note
Funding Information:Supported by grant Nos. U01DE017018 and P01NS045685 from the National Institutes of Health (Bethesda, Maryland) and institutional support from the Department of Anesthesiology, Duke University, Durham, North Carolina.
Publisher Copyright:
© 2019, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved.