Skip to main content

Advertisement

SpringerLink
Log in

Analgesia nociception index (ani) monitoring in patients with thoracic paravertebral block: a randomized controlled study

  • Original Research
  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

The goal of the study was to evaluate the effectiveness of analgesia nociception index (ANI) monitoring during intraoperative period for patients with thoracic paravertebral block (TPVB) undergoing breast surgery under general anesthesia. This prospective randomized trial was performed after receiving ethics committee approval in 44 patients who were scheduled to undergo breast surgery under general anesthesia. TPVB was performed in the preoperative period using 20 mL of bupivacaine 0.25% at T4 level. Anesthesia maintenance was provided with sevoflurane in O2: air mixture and remifentanil infusion. Intraoperative concentration of sevoflurane was adjusted according to BIS monitoring keeping the values between 40–60. In a randomized manner patients were divided into two groups. In Group control (n:22) intraoperative remifentanil infusion rate was regulated according to hemodynamic parameters, in Group ANI (n:22) remifentanil infusion rate was titrated to keep ANI monitoring values between 50–70. Total remifentanil consumption was recorded as micrograms. Demographic data, anesthesia and surgery time, intraoperative hemodynamic parameters, post-anesthesia recovery time and requirement of additional analgesic in the recovery drug were recorded. There were no significant difference in demographic data, intraoperative hemodynamic parameters, post-anesthesia recovery time and requirement of additional analgesic drug. There was a statistically significant difference between groups in total remifentanil consumption (Group ANI: 629.6 ± 422.4 mcg, Group control: 965.2 ± 543.6 mcg) (p = 0.027). In patients under general anesthesia ANI monitorisation can help optimisation of opioid consumption and provide data about nociception/antinociception intraoperatively but further experimental and clinical trials in a large scale are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Migeon A, Desgranges FP, Chassard D, et al. Pupillary reflex dilatation and analgesia nociception index monitoring to assess the effectiveness of regional anesthesia in children anesthetised with sevoflurane. Paediatr Anaesth. 2013;23:1160–5.

    PubMed  Google Scholar 

  2. Le Guen M, Jeanne M, Sievert K, et al. The analgesia nociception index: a pilot study to evaluation of a new pain parameter during labor. Int J Obstet Anesth. 2012;21:146–51.

    Article  CAS  PubMed  Google Scholar 

  3. Gruenewald M, Ilies C, Herz J, et al. Influence of nociceptive stimulation on analgesia nociception index (ani) during propofol-remifentanil anaesthesia. Br J Anaesth. 2013;110:1024–30.

    Article  CAS  PubMed  Google Scholar 

  4. Ledowski T, Averhoff L, Tiong WS, Lee C. Analgesia nociception index (ani) to predict intraoperative haemodynamic changes: results of a pilot investigation. Acta Anaesthesiol Scand. 2014;58:74–9.

    Article  CAS  PubMed  Google Scholar 

  5. De Jonckheere J, Rommel D, Nandrino JL, Jeanne M, Logier R. Heart rate variability analysis as an index of emotion regulation processes: interest of the analgesia nociception index (ani). In: Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2012;2012:3432–5.

  6. Logier R, Jeanne M, De Jonckheere J, Dassonneville A, Delecroix M, Tavernier B. Physiodoloris: a monitoring device for analgesia/nociception balance evaluation using heart rate variability analysis. In: Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2010;2010:1194–7.

  7. Boselli E, Daniela-Ionescu M, Begou G, et al. Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ani). Br J Anaesth. 2013;111:453–9.

    Article  CAS  PubMed  Google Scholar 

  8. Gall O, Champigneulle B, Schweitzer B, et al. Postoperative pain assessment in children: a pilot study of the usefulness of the analgesia nociception indexdagger. Br J Anaesth. 2015;115:890–5.

    Article  CAS  PubMed  Google Scholar 

  9. Richardson J, Lonnqvist PA, Naja Z. Bilateral thoracic paravertebral block: potential and practice. Br J Anaesth. 2011;106:164–71.

    Article  CAS  PubMed  Google Scholar 

  10. De jonckheere J, Delecroix M, Jeanne M, Keribedj A, Couturier N, Logier R. Automated analgesic drugs delivery guided by vagal tone evaluation: interest of the analgesia nociception index (ani). In: Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2013;2013:1952–5.

  11. Logier R, De Jonckheere J, Delecroix M ve ark. Heart rate variability analysis for arterial hypertension etiological diagnosis during surgical procedures under tourniquet.In: Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference. 2011;2011:3776–9.

  12. Sabourdin N, Arnaout M, Louvet N, Guye ML, Piana F, Constant I. Pain monitoring in anesthetized children: first assessment of skin conductance and analgesia-nociception index at different infusion rates of remifentanil. Paediatr Anaesth. 2013;23:149–55.

    Article  PubMed  Google Scholar 

  13. Jeanne M, Logier R, De Jonckheere J, Tavernier B. Heart rate variability during total intravenous anesthesia: Effects of nociception and analgesia. Auton Neurosci. 2009;147:91–6.

    Article  CAS  PubMed  Google Scholar 

  14. Terheggen MA, Wille F, Borel Rinkes IH, Ionescu TI, Knape JT. Paravertebral blockade for minor breast surgery. Anesth Analg. 2002;94:355–9. (Table of contents).

    PubMed  Google Scholar 

  15. Weltz CR, Klein SM, Arbo JE, Greengrass RA. Paravertebral block anesthesia for inguinal hernia repair. World J Surg. 2003;27:425–9.

    Article  PubMed  Google Scholar 

  16. Pei L, Zhou Y, Tan G, et al. Ultrasound-assisted thoracic paravertebral block reduces intraoperative opioid requirement and improves analgesia after breast cancer surgery: A randomized, controlled, single-center trial. PloS ONE. 2015;10:e0142249.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Jeanne M, Clement C, De Jonckheere J, Logier R, Tavernier B. Variations of the analgesia nociception for laparoscopic abdominal surgery. J Clin Monit Comput. 2012;26:289–94.

    Article  CAS  PubMed  Google Scholar 

  18. Boselli E, Logier R, Bouvet L, Allaouchiche B. Prediction of hemodynamic reactivity using dynamic variations of analgesia/nociception index (∆ANI). J Clin Monit Comput. 2016;30:977–84.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, School of Medicine, Kocaeli University, Kocaeli, Turkey

    Nurseda Dundar, Alparslan Kus, Yavuz Gurkan & Mine Solak

  2. Department of Anesthesiology and Reanimation, School of Medicine, Bahçeşehir University, Istanbul, Turkey

    Kamil Toker

Authors
  1. Nurseda Dundar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alparslan Kus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yavuz Gurkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kamil Toker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mine Solak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nurseda Dundar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dundar, N., Kus, A., Gurkan, Y. et al. Analgesia nociception index (ani) monitoring in patients with thoracic paravertebral block: a randomized controlled study. J Clin Monit Comput 32, 481–486 (2018). https://doi.org/10.1007/s10877-017-0036-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-017-0036-9

Keywords

Search

Navigation