Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI)

Boselli, Emmanuel; Daniela-Ionescu, M; Bégou, Gérard; Bouvet, Lionel; Dabouz, R.; Magnin, C.; Allaouchiche, Bernard

doi:10.1093/bja/aet110

Cited by 114 publications

(113 citation statements)

References 26 publications

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“…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%

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%

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

Daoust

Paquet

Bailey

et al. 2015

CJEM

View full text Add to dashboard Cite

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“…Son birkaç yılda, anestezinin dört temel öğesinden biri olan analjezi ve otonom reflekslerin, anestezistin deneyimi dışında objektif olarak değerlendirebilecek farklı parametreler üzerinde çalışılmıştır (24)(25). Bunlardan en önemlilerinden biri de çalışma grubumuzda kullandığımız ANİ'dir (8,9,26). KAH değişkenliğinden yararlanan bu indekste yeterli analjezi varlığında değişkenlik sadece solunumsal aritmiden kaynaklanır ve bu durum parasempatik tonus hakimiyetini gösterir.…”

Section: Discussionunclassified

“…Anestezi sırasında parasempatik otonom sinir sisteminin tonusunu ölçerek nosisepsiyon-analjezi dengesini ve dolayısıyla peroperatuvar dönemde analjezi yeterliliğini gösteren Analjezi Nosisepsiyon indeksi [ANİ, (Metrodolaris, Fransa)] yeni bir parametre olarak son yıllarda ortaya çıkmıştır (8,9). ANİ, kalp hızı varyasyonları içinde iki R dalgası arasındaki zaman aralığının solunum siklusu ile değişkenliğinin filtre edilerek ölçülmesi ve değerlendirilmesiyle elde edilen parasempatik tonusu (p∑) gösteren, 0-100 arasında değişen sayısal bir değerdir.…”

Section: Introductionunclassified

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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“…Several methods have been proposed to assess and quantitate the nociceptive response during general anesthesia [8][9][10][11] Autonomic nervous system measures, for example Heart Rate Variability (HRV) [12] or Skin Conductance (SC) [13] and parameters extracted, have been proposed and used by several authors. HRV and SC are correlated with sympathetic activity and therefore, monitors based on these parameters can measure the increase in sympathetic activity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery

Melia¹,

Gabarron²,

Agustí

et al. 2016

J Clin Monit Comput

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Purpose. The objective of this work is to compare the behavior of two electroencephalogram (EEG) based indices after drug induction and during recovery of consciousness.Methods. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. The qCON 2000 monitor (Quantium Medical, Barcelona, Spain) was used to calculate the qCON and qNOX. The fall times and the rise times were defined at the start and at the end of the surgery. Loss of response to verbal command and loss of eye-lash reflex were assessed during the transition from awake to anesthetized, defining the state of loss of consciousness (LOC). Movement as a response to laryngeal mask (LMA) insertion was interpreted as the response to the nociceptive stimuli. The patients were classified as movers or non-movers. The values of qCON and qNOX were statistically compared. Conclusion.The indices qCON and qNOX were able to detect differences between the times of actions of hypnotic and analgesic agents. The qCON showed faster decrease during induction while the qNOX showed a faster increase during recovery.

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Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI)

Abstract: A measurement of ANI during the immediate postoperative period is significantly correlated with pain intensity. The measurement of ANI appears to be a simple and non-invasive method to assess immediate postoperative analgesia.

Cited by 114 publications

References 26 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

Comparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery

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