Vincent Bonhomme

University of Liège | ulg · Department of Anesthesia and Intensive Care

Background/Objectives: Hypnosis shows great potential for managing patients suffering from fibromyalgia and chronic pain. Several studies have highlighted its efficacy in improving pain, quality of life, and reducing psychological distress. Despite its known feasibility and efficacy, the mechanisms of action remain poorly understood. Building on th...

Experimental and clinical studies of consciousness identify brain states (i.e. quasi-stable functional cerebral organization) in a non-systematic manner and largely independent of the research into brain state modulation. In this narrative review, we synthesize advances in the identification of brain states associated with consciousness in animal m...

Damage to the brain can have disastrous and long-lasting consequences. The European Society of Anaesthesiology and Intensive Care (ESAIC) is aware of the importance of taking good care of the brain, both of patients and of anaesthesia and intensive care unit (ICU) caregivers, and has organised a complete learning track on brain health to bring this...

When used separately, virtual reality (VR) and mind-body therapies (MBTs) have the potential to reduce pain across various acute and chronic conditions. While their combination is increasingly used, no study offers a consolidated presentation of VR and MBTs. This study aims to propose an overview of the effectiveness of VR combined with MBTs (i.e.,...

Disorders of consciousness (DoC), including the unresponsive wakefulness syndrome (UWS) and the minimally conscious state (MCS), have limited treatment options. Recent research suggests that psychedelic drugs, known for their complexity-enhancing properties, could be promising treatments for DoC. This study uses whole-brain computational models to...

Ketamine is classified as a dissociative anaesthetic that, in sub-anaesthetic doses, can produce an altered state of consciousness characterised by dissociative symptoms, visual and auditory hallucinations, and perceptual distortions. Given the anaesthetic-like and psychedelic-like nature of this compound, it is expected to have different effects o...

Introduction It is still unclear whether enhanced recovery programs (ERPs) reduce postoperative morbidity after liver surgery. This study investigated the effect on liver surgery outcomes of labeling as a reference center for ERP. Materials and methods Perioperative data from 75 consecutive patients who underwent hepatectomy in our institution aft...

Background and objectives Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty...

Background The management of chronic pain may involve an array of tools, including radiofrequency thermocoagulation (Rf-Tc) of sensory nerve terminals. Like many other invasive procedures, Rf-Tc can generate anxiety in a lot of patients, either during the expectation of the procedure or in the course of it. Virtual reality hypnosis (VRH) is a promi...

Background Disconnected consciousness describes a state in which subjective experience (i.e., consciousness) becomes isolated from the external world. It appears frequently during sleep or sedation, when subjective experiences remain vivid but are unaffected by external stimuli. Traditional methods of differentiating connected and disconnected cons...

BACKGROUND Human consciousness is generally thought to emerge from the activity of intrinsic connectivity networks (resting-state networks [RSNs]) of the brain, which have topological characteristics including, among others, graph strength and efficiency. So far, most functional brain imaging studies in anesthetized subjects have compared wakefulne...

BACKGROUND Oral as compared to intravenous tranexamic acid (TXA) is an attractive option, in terms of cost and safety, to reduce blood loss and transfusion in total hip arthroplasty. Exclusion criteria applied in the most recent randomised trials may have limited the generalisability of oral tranexamic acid in this indication. Larger and more inclu...

Following up on the successful BeSARPP annual meeting on sustainability in anesthesia held on November 2022, the Board Members of BeSARPP met to draft recommendations regarding the use of inhaled anesthetics, that would help anesthesiologists decrease the professional environmental impact of their daily practice in the operating room. This manuscri...

Please confirm that an ethics committee approval has been applied for or granted Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission Application for ESRA Abstract Prizes I apply as an Anesthesiologist (Aged 35 years old or less) Background and Aims Pain after posterolateral-approached total hip arthroplast...

Introduction Gautier et al. demonstrated that a compression in the left paratracheal region (left paratracheal pressure, LPP) can be used to seal the oesophagus. However, at this level, the left common carotid artery is very close to the carotid that could be affected during the manipulation. This study aimed to assess the hemodynamic effects of LP...

Background: Intraoperative hypothermia is associated with increased morbidity and impaired postoperative recovery. Direct anterior-approached total hip arthroplasty (ATHA) may lead to significant thermal loss. We aimed to assess whether preoperative warming had an impact on intraoperative hypothermia and postoperative functional recovery after ATH...

Traumatic Brain Injury (TBI) is a common trauma and a worldwide major cause of mortality or disability in both civilian and military populations. TBI is not a pathological entity in its own, but rather a pattern of heterogeneous traumas with diverse and varied mechanisms and clinical expressions. Therefore, no universal medical response can be sett...

Neuroscientists agree on the value of locating the source of consciousness within the brain. Anaesthesiologists are no exception, and have their own operational definition of consciousness based on phenomenological observations during anaesthesia. The full functional correlates of consciousness are yet to be precisely identified, however rapidly ev...

Background: Postoperative delirium (POD) remains a frequent complication after cardiac surgery, with pre-operative cognitive status being one of the main predisposing factors. However, performing complete pre-operative neuropsychological testing is challenging. The magnitude of frontal electroencephalographic (EEG) α oscillations during general an...

Introduction The prevalence of chronic knee pain is increasing. Osteoarthritis (OA) and persistent postsurgical pain (PPSP) are two important causes of knee pain. Chronic knee pain is primarily treated with medications, physiotherapy, life-style changes and intra-articular infiltrations. A radiofrequency treatment (RF) of the genicular nerves is a...

Objective: To assess the safety of "on-table" extubation after minimally-invasive heart valve surgery. Design: A single-center retrospective observational study. Setting: At a tertiary referral academic hospital. Participants: Patients who underwent nonemergent isolated heart valve surgery through a minithoracotomy approach between January 2...

Background: Cortical excitability is higher in unconsciousness than in wakefulness, but it is unclear how this relates to anaesthesia. We investigated cortical excitability in response to dexmedetomidine, the effects of which are not fully known. Methods: We recorded transcranial magnetic stimulation (TMS) and EEG in frontal and parietal cortex...

Background: Pain after a posterolateral approach for total hip arthroplasty (THA) may affect early functional recovery. Supra-inguinal fascia iliaca (SFIB) and pericapsular nerve group (PENG) blocks have been proposed as promising analgesia techniques. Objectives: This trial was conducted to compare a PENG with a SFIB for controlling postoperati...

To understand how pharmacological interventions can exert their powerful effects on brain function, we need to understand how they engage the brain's rich neurotransmitter landscape. Here, we bridge microscale molecular chemoarchitecture and pharmacologically induced macroscale functional reorganization, by relating the regional distribution of 19...

Background and Goal of Study: Intraoperative hypothermia (IH) increases postoperative morbidity and impairs postoperative recovery.1 Anterior-approached total hip arthroplasty (ATHA) can be associated with significant IH, partly due to the exposed body surface area in the operative field.2,3 This trial was conducted to assess the interest of prepar...

Since their first approval in 2010, direct oral anticoagulants (DOACs) have become attractive for anticoagulant treatment. DOACs are indicated for the prevention and treatment of several cardiovascular conditions and have now emerged as leading therapeutic options. Every year, large number of patients receiving DOACs routinely are scheduled for inv...

Aneurysmal subarachnoid hemorrhage (aSAH) is an emergency that needs prompt diagnosis and treatment with endovascular coiling or surgical clipping of the aneurysm to prevent re-bleeding. In addition to neurologic manifestations, aSAH can cause respiratory and cardiovascular complications. The prevention of hypoxemia and hypercarbia, control of intr...

Objectives: The authors aimed to develop a simple prediction score to help identify patients at high risk of low-cardiac-output syndrome after adult cardiac surgery. Design: A single-center, retrospective, observational study. Setting: At a tertiary hospital. Participants: Adult patients who underwent on-pump cardiac surgery between April 20...

Brain states are frequently represented using a unidimensional scale measuring the richness of subjective experience (level of consciousness). This description assumes a mapping between the high-dimensional space of whole-brain configurations and the trajectories of brain states associated with changes in consciousness, yet this mapping and its pro...

Fibromyalgia remains a nebulous clinical entity for many practitioners. Actually, this pathology associates diffuse chronic pain with a host of somatic complaints, which may be variable from one patient to another. The difficulty resides also in establishing the diagnosis, which remains essentially clinical, in the absence of anatomical lesions, as...

The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and manage...

Background and study aim: Revision of total hip arthroplasty (rTHA) is associated with significant blood loss. We have used intraoperative cell savage (ICS) systematically in these patients for the last ten years. We sought to determine how often re-suspended red blood cells could be re-transfused and to identify predictors of re- transfusion. Mate...

Pain is generally perceived as a sensory, emotional and cognitive aggression by the patient who suffers from it and as the enemy that must be defeated by the physician. It may become chronic, and the passage from the acute phase to the chronic phase cannot be explained in a single way. Indeed, multiple factors come into play: biological, psychologi...

Brain states are frequently represented using a unidimensional scale measuring the richness of subjective experience (level of consciousness). This description assumes a mapping between the high-dimensional space of whole-brain configurations and the trajectories of brain states associated with changes in consciousness, yet this mapping and its pro...

We aimed at determining whether the Erector Spinae Plane (ESP) block is useful for providing anti-nociception and analgesia to patients beneficiating from lumbar spine surgery. Using the keywords “Erector Spinae Plane block” and “lumbar” or “spinal surgery” in Pubmed, the Cochrane Library Database, and Google Scholar (end of search in March 2021),...

Naturally occurring sleep and altered consciousness related to the infusion of sedative medications are sometimes mistakenly thought of as being equivalent. While similarities between these two states do exist, differences are considerable and clinically important. Normal sleep is characterized by a cyclic, organized series of brain activities with...

Background The safety of anaesthesia has improved as a result of better control of anaesthetic depth. However, conventional monitoring does not inform on the nature of nociceptive processes during unconsciousness. A means of inferring the quality of potentially painful experiences could derive from analysis of brain activity using neuroimaging. We...

Introduction: Posterolateral-approached total hip arthroplasty (PLTHA) is followed by moderate to severe postoperative pain. Suprainguinal fascia iliaca compartment block (SFICB) has been proposed as a promising analgesia technique. Methods: Data from 86 patients scheduled for PLTHA with spinal anesthesia were analyzed in this prospective random...

Background and Aims Hip fracture (HF) exacerbates loss of autonomy in the elderly.Several studies focus on improving outcome by intervening on one single aspect of perioperative management.¹We aimed to observewhether a multidisciplinary management algorithm rather than a single change to a single aspect of perioperative management had an impact on...

Background and Aims Pain after posterolateral-approachedtotal hip arthroplasty (PLTHA) may affect early functional recovery.Supra-inguinal fascia iliaca (SFICB) and pericapsular nerve group blocks (PENG) have been proposed as promising analgesia techniques.1–3This trial was conducted to assess non-inferiority of PENG as compared to SFICB for contro...

Background and Aims The aim of this study is the description of an ultrasound-guided brachial plexus blockade at the level of the head of humerus where nerves are grouped around the axillary artery Methods Ethics committee (CHU Liège. 2017/139–140) approved this study. 20 patients scheduled for hand and forearm surgeries were blocked in supine pos...

Background Connected consciousness, assessed by response to command, occurs in at least 5% of general anaesthetic procedures and perhaps more often in young people. Our primary objective was to establish the incidence of connected consciousness after tracheal intubation in young people aged 18–40 yr. The secondary objectives were to assess the natu...

Introduction Active lumbar discopathy (ALD) refractory to conservative treatment can be treated with interbody fusion. Surgical options include antero-lateral interbody fusion (ALIF) and postero-lateral interbody fusion (PLIF). The aim of this study was to assess the long-term functional outcome and complications rates related to both techniques....

Background Several continuous monitoring solutions, including wireless wearable sensors, are available or being developed to improve patient surveillance on surgical wards. We designed a survey to understand the current perception and expectations of anaesthesiologists who, as perioperative physicians, are increasingly involved in postoperative car...

Consciousness can be defined by two components: arousal (wakefulness) and awareness (subjective experience). However, neurophysiological consciousness metrics able to disentangle between these components have not been reported. Here, we propose an explainable consciousness indicator (ECI) using deep learning to disentangle the components of conscio...

Purpose Electrical stimulation of the sub-thalamic nucleus (STN-DBS) is well established to alleviate motor fluctuations in advanced Parkinson’s disease but little is known about its very long-term efficacy. Methods We followed over 12 years 15 parkinsonian patients having undergone STN-DBS and compared them to a matched group of 14 patients with...

Sedation is frequently an integral part of treatment in brain-injured patients and has general and specific indications. Sedation may also have detrimental consequences for those patients. Hence, the choice of sedation is of utmost importance for their management and should be done on an individual basis. This choice should take account of the type...

The dynamic core hypothesis posits that consciousness is correlated with simultaneously integrated and differentiated assemblies of transiently synchronized brain regions. We represented time-dependent functional interactions using dynamic brain networks and assessed the integrity of the dynamic core by means of the size and flexibility of the larg...

Consciousness transiently fades away during deep sleep, more stably under anesthesia, and sometimes permanently due to brain injury. The development of an index to quantify the level of consciousness across these different states is regarded as a key problem both in basic and clinical neuroscience. We argue that this problem is ill-defined since su...

Intracerebroventricular (ICV) infusion of morphine is a well-known technique to relieve intractable neoplasic pain when conventional analgesic strategies reach their limits. Through this case report, we present indications, assets, and drawbacks of this procedure in such conditions. We also describe the adaptation of the systemic analgesic treatmen...

Background Cortical excitability changes across conscious states, being higher in unconsciousness compared to normal wakefulness. Anaesthesia offers controlled manipulation to investigate conscious processes and underlying brain dynamics. Among commonly used anaesthetic agents, dexmedetomidine (DEX) effects are not completely known. In this study,...

In recent years, specific cortical networks have been proposed to be crucial for sustaining consciousness, including the posterior hot zone and frontoparietal resting state networks (RSN). Here, we computationally evaluate the relative contributions of three RSNs – the default mode network (DMN), the salience network (SAL), and the central executiv...

A classic example of phenotypic plasticity in plants is the set of traits that change in response to shade. There is widespread evidence that plants in low light conditions often avoid shade by growing taller or by increasing their photosynthetic efficiency, i.e. the shade avoidance syndrome. Whether this plasticity might evolve in response to natu...

In recent years, specific cortical networks have been proposed to be crucial for sustaining consciousness, including the posterior hot zone and frontoparietal resting state networks (RSN). Here, we computationally evaluate the relative contributions of three RSNs – the default mode network (DMN), the salience network (SAL), and the central executiv...

The dynamic core hypothesis posits that consciousness is correlated with simultaneously integrated and differentiated assemblies of transiently synchronized brain regions. We represented time-dependent functional interactions using dynamic brain networks, and assessed the integrityof the dynamic core by means of the flexibility and largest multilay...

Background: The anesthetic management of supratentorial craniotomy (CR) necessitates tight intraoperative hemodynamic control. This type of surgery may also be associated with substantial postoperative pain. We aimed at evaluating the influence of regional scalp block (SB) on hemodynamic stability during the noxious events of supratentorial cranio...

We introduce a mean-field model for analysing the dynamics of human consciousness. In particular, inspired by the Giulio Tononi's Integrated Information Theory and by the Max Tegmark's representation of consciousness, we study order–disorder phase transitions on Curie–Weiss models generated by processing EEG signals. The latter have been recorded o...

Consciousness transiently fades away during deep sleep, more stably under anesthesia, and sometimes permanently due to brain injury. The development of an index to quantify the level of consciousness across these different states is regarded as a key problem both in basic and clinical neuroscience. We argue that this problem is ill-defined since su...

Neuroscience has generated a number of recent advances in the search for the neural correlates of consciousness, but these have yet to find valuable real-world applications. Electroencephalography under anesthesia provides a powerful experimental setup to identify electrophysiological signatures of altered states of consciousness, as well as a test...

Objectives: The short and middle-term multicolumn-lead spinal cord stimulation (SCS) control of back pain (BP) and leg pain (LP) in Failed Back Surgery Syndrome (FBSS) patients is well documented. Our study aimed at investigating whether SCS remains efficient after 72 months. Patients and methods: In an observational and single-center study, we...

We introduce a mean-field model for analysing the dynamics of human consciousness. In particular, inspired by the Giulio Tononi's Integrated Information Theory and by the Max Tegmark's representation of consciousness, we study order-disorder phase transitions on Curie-Weiss models generated by processing EEG signals. The latter have been recorded o...

How are the brain's large scale networks affected by unconsciousness induced by anaesthetic drug? Here, using dynamic causal modeling for cross-spectral densities (as measured from high-density EEG), we investigated the directed connectivity modulations in three resting state networks (RSN) during propofol-induced unresponsiveness. Our findings dem...

General anesthesia reversibly alters consciousness, without shutting down the brain globally. Depending on the anesthetic agent and dose, it may produce different consciousness states including a complete absence of subjective experience (unconsciousness), a conscious experience without perception of the environment (disconnected consciousness, lik...

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 EEGÀderived indexes of the depth of the hypnotic component...

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©) are commercial devices that use different algorithms t...

What we already know about this topic: The extent to which alterations within specific brain networks impairs communication among networks remains unknown WHAT THIS ARTICLE TELLS US THAT IS NEW: In a volunteer functional magnetic resonance study, general anesthesia reduced activity within and among networksSpecific between-network connectivity is...