Analgesia nociception index: evaluation as a new parameter for acute postoperative pain

Ledowski, Thomas; Tiong, W.S.; Lee, C; Wong, Bessie; Fiori, T; Parker, Noah P.

doi:10.1093/bja/aet111

Cited by 106 publications

(102 citation statements)

References 10 publications

(9 reference statements)

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“…29,30 Some studies do not support this association. [35][36][37][38] Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) have been associated with pain intensity. 24,26 However, as was the case for HR, other investigations reported an absence of relationship.…”

Section: Introductionmentioning

confidence: 99%

“…22,24,26,28,31,33,37,39 Transcutaneous oxygen, skin conductance, and the analgesia/nociception index (calculated from HR variability) have been assessed in patients experiencing pain with inconsistent conclusions. 23,27,31,32,34,38,[40][41][42] Patients with severe pain who show no hypertension or tachycardia to substantiate their pain intensity might not receive the aggressive pain treatment they warrant. Our study aimed to determine whether vital signs are associated with pain intensity levels in both the ED population and a subgroup of patients with diagnosed conditions recognized to produce significant pain.…”

Section: Introductionmentioning

confidence: 99%

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Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Daoust

Paquet

Bailey

et al. 2015

CJEM

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Objectives: This study aimed to ascertain the association between self-reported pain intensity and vital signs in both emergency department (ED) patients and a subgroup of patients with diagnosed conditions known to produce significant pain. Methods: We performed a retrospective analysis of real-time, archived data from an electronic medical record system at an urban teaching hospital and regional community hospital. We included consecutive ED patients ≥16 years old who had a self-reported pain intensity ≥1 as measured during triage, from March 2005 to December 2012. The primary outcome was vital signs for self-reported pain intensity levels (mild, moderate, severe) on an 11-point verbal numerical scale. Changes in pain intensity levels were also compared to variations in vital signs. Both analyses were repeated on a subgroup of patients with diagnosed conditions recognized to produce significant pain: fracture, dislocation, or renal colic. Results: We included 153,567 patients (mean age of 48.4 ± 19.3 years; 55.5% women) triaged with pain (median intensity of 7/10 ± 3). Of these, 8.9% of patients had diagnosed conditions recognized to produce significant pain. From the total sample, the difference between mild and severe pain categories was 2.7 beats/minutes (95% CI: 2.4 − 3.0) for heart rate and 0.13 mm Hg (95% CI: -0.26 − 0.52) for systolic blood pressure. These differences generated small effect sizes and were not clinically significant. Results were similar for patients who experienced changes in pain categories and for those conditions recognized to produce significant pain. Conclusion: Health care professionals cannot use vital signs to estimate or substantiate self-reported pain intensity levels or changes over time. RÉSUMÉObjectif: L'étude visait à confirmer l'existence d'une association entre l'intensité de la douleur autodéclarée et les signes vitaux enregistrés chez des patients au service des urgences (SU) ainsi que dans un sous-groupe de malades souffrant d'affections connues pour causer de fortes douleurs. Méthode: Les auteurs ont procédé à une analyse rétro-spective de données enregistrées en temps réel et archivées dans un système de dossiers médicaux électroniques, dans un centre hospitalier universitaire urbain et dans un hôpital communautaire régional. Ont participé à l'étude des patients consécutifs, âgés de ≥16 ans, qui ont fait état, au SU, de douleurs d'une intensité ≥1, mesurée durant le triage, de mars 2005 à décembre 2012. Le principal critère d'évaluation était les signes vitaux associés à différents degrés d'intensité (légère, modérée, forte) de la douleur autodéclarée sur une échelle numérique, verbale, de 11 points. Les variations de l'intensité de la douleur ont également été comparées aux variations des signes vitaux. Les deux analyses ont été reprises dans un sous-groupe de patients souffrant d'affections connues pour causer de fortes douleurs: fracture, luxation ou colique néphrétique. Résultats: Ont participé à l'étude 153 567 patients (âge moyen: 48,4 ± 19,3 ans; femm...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Daoust

Paquet

Bailey

et al. 2015

CJEM

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“…Hemen operasyon sonrası saptanan ANİ değerinin oluşacak postoperatuvar ağrının şiddetini tahmin etmek için kullanılmasına yönelik çalışmalar devam etmektedir. Ancak sadece hemodinamik etkileşimin değil, ağrı yoğunluğunun ANİ kullanılarak erken ön görülmesi konusunda da henüz fikir birliği oluşmamış olup, bunun aksini bildiren araştırmalar da vardır (33,34). Kliniğimizde de bu konuda çalışmalar devam etmektedir.…”

Section: Discussionunclassified

Prediction of Hemodynamic Reactivity during Sevoflurane Remifentanyl Anesthesia for Laparoscopic Cholecystectomy Using Analgesia Nociception Index

Köprülü¹,

Toptaş²,

Gül³

et al. 2016

Haseki

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“…It provides a continuous reading, creating a score from 0-100 where numbers over 50 are thought to reflect adequate analgesia. ANI scores respond reliably to surgical stimuli under anesthesia [16,17], however, there have been inconsistent results regarding a linear relationship with post-operative self-reported pain intensity scores [18][19][20]. Furthermore, the use of ANI to titrate intraoperative opioids has not demonstrated improved postoperative analgesia compared to normal practice.…”

Section: Introductionmentioning

confidence: 99%

Objective Assessment of Acute Pain

Laycock¹,

Bantel²

2016

General Anesthesia and Sleep

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Analgesia nociception index: evaluation as a new parameter for acute postoperative pain

Abstract: ANI did not reflect different states of acute postoperative pain measured on a NRS scale after adult sevoflurane-based general anaesthesia.

Cited by 106 publications

References 10 publications

Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Vital Signs Are Not Associated with Self-Reported Acute Pain Intensity in the Emergency Department

Prediction of Hemodynamic Reactivity during Sevoflurane Remifentanyl Anesthesia for Laparoscopic Cholecystectomy Using Analgesia Nociception Index

Objective Assessment of Acute Pain

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