Validation of three nociception indices to predict immediate postoperative pain before emergence from general anaesthesia: a prospective double-blind, observational study

Opioid-free anaesthesia: should we all adopt it? An overview of current evidence: a reply

“…None used paracetamol. Although we agree that promoting paracetamol use is reasonable seeing the limited side effects, it has been well shown that the opioid-sparing effect of paracetamol is not always linked to any significant decrease in nausea and vomiting, or even pain scores, 6 and combination in high-dose ranges might not increase benefit of one drug alone. In other words, even if we recommend the use of paracetamol, its absence probably did not affect the validity of the two studies, given the already low…”

“…A recent study shows that nociception levels measured prior to emergence from general anaesthesia are not correlated to postoperative pain. 6 In addition to these oversights, the editorial by Forget et al 1 has several inaccuracies. The authors state that there is abundant documentation of the feasibility of OFA, including cohorts of more than 20 000 patients.…”

Surgical pleth index monitoring in perioperative pain management: usefulness and limitations

“…In addition, three devices to predict immediate postoperative pain after arousal from general anesthesia were investigated among the three devices (SPI, PPI, and NOL). The study concluded that none of these monitors alone had sufficient diagnostic accuracy for predicting postoperative pain [65], suggesting that a combination of nociceptive indices and clinical factors may increase the accuracy of postoperative pain prediction. This article is protected by copyright of Korean Journal of Anesthesiology.…”

Neue Ansätze in der perioperativen Algesimetrie

“…Hierbei wurden bei Kindern Werte von SPI > 40 und bei Erwachsenen SPI > 30 (gemessen am Ende der Narkose) als Hinweis auf stärkere Schmerzen im Aufwachraum publiziert [30,32]. Zumindest bei Erwachsenen wurde der klinische Nutzen eines solchen Cut-off-Wertes in nachfolgenden Validierungsstudien allerdings deutlich bezweifelt [33,34]. Intraoperativ scheint SPI keine Prädiktion einer Reaktion auf einen Schmerzreiz zu erlauben [35].…”

“…Bei Kindern zeigte eine Untersuchung von Chemam et al, dass NOL in der Lage war, experimentelle Schmerzreize während einer Narkose relativ gut abzubilden [76]. Zur Prädiktion akuter postoperativer Schmerzen wurde NOL als relativ ungeeignet eingestuft [77,78]. Punkte sammeln auf CME.thieme.de…”