Education  |   April 2019
Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes
Author Notes
  • From the Center for Translational Pain Medicine (H.S.-R., R.-R.J., W.M.) and the Division of Cardiothoracic Anesthesia and Critical Care Medicine (R.Y.K., M.V.P., M.I.S., N.W., J.P.M.), Department of Anesthesiology, Duke University, Durham, North Carolina.
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Submitted for publication February 7, 2018. Accepted for publication October 8, 2018.
    Submitted for publication February 7, 2018. Accepted for publication October 8, 2018.×
  • Address correspondence to Dr. Maixner: Center for Translational Pain Medicine, Department of Anesthesiology, Room 2031, Genome Science Building, 905 South LaSalle Street, Duke University, Durham, North Carolina 27705. william.maixner@duke.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Review Article / Central and Peripheral Nervous Systems / Pain Medicine
Education   |   April 2019
Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes
Anesthesiology 4 2019, Vol.130, 634-650. doi:10.1097/ALN.0000000000002510
Anesthesiology 4 2019, Vol.130, 634-650. doi:10.1097/ALN.0000000000002510
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.