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Journal of Clinical Monitoring and Computing

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28.02.2020 | Original Research

Usefulness of ANI (analgesia nociception index) monitoring for outpatient saphenectomy surgery outcomes: an observational study

verfasst von: Adolfo Ramos-Luengo, Adela Gardeta Pallarés, Fernando Asensio Merino

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 3/2021

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Abstract

The Analgesia Nociception Index (ANI), derived from heart rate variability is a proposed guide to obtain an adequate control of the analgesic component during anaesthesia. This single blind observational study was designed to evaluate the relationship between intraoperative ANI values and length of stay in Day Surgery Units (DSU) in patients undergoing varicose vein intervention. 131 patients (ASA I-II) scheduled for elective varicose vein surgery were studied. A propofol closed-loop TCI was used to maintain a specific level of BIS. To control analgesia, a remifentanil TCI was used, modifying the target according to hemodynamic changes. Patients were included in the ANI > 50 sub-group or in the ANI < 50 sub-group depending on whether the ANI value was greater than 50 for at least 60% of the anaesthesia maintenance period (AMP) or not. The primary endpoint was the length of stay in DSU. Other variables studied were ANI values, duration of the AMP, remifentanil TCI target average, postoperative pain, rescue-analgesia needs and postoperative nausea and vomiting (PONV) were analysed. Statistical analysis of length of stay in DSU was performed with Mann–Whitney test. ANI > 50 sub-group showed a lower length of stay in the DSU [165 min (118–212) vs 186.5 min (119–254), p = 0.0425]. Discharge timing from DSU was statistically different among study sub-groups (p = 0.005). An adequate nociception level measured by ANI during varicose vein surgery might reduce the length of stay at DSU. Further studies are needed to assess the usefulness of ANI in other anaesthesia conditions.

Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131–57. https://doi.org/10.1016/j.jpain.2015.12.008.CrossRefPubMed

Merskey H. Logic, truth and language in concepts of pain. Qual Life Res. 1994;3(Suppl 1):S69–76. https://doi.org/10.1007/bf00433379.CrossRefPubMed

Loeser JD, Treede RD. The kyoto protocol of IASP basic pain terminology. Pain. 2008;137(3):473–7. https://doi.org/10.1016/j.pain.2008.04.025.CrossRefPubMed

Ledowski T. Objective monitoring of nociception: a review of current commercial solutions. Br J Anaesth. 2019;123(2):e312–e321321. https://doi.org/10.1016/j.bja.2019.03.024.CrossRefPubMedPubMedCentral

Ledowski T, Reimer M, Chavez V, Kapoor V, Wenk M. Effects of acute postoperative pain on catecholamine plasma levels, hemodynamic parameters, and cardiac autonomic control. Pain. 2012;153(4):759–64. https://doi.org/10.1016/j.pain.2011.11.002.CrossRefPubMed

Boselli E, Bouvet L, Begou G, Torkmani S, Allaouchiche B. Prediction of hemodynamic reactivity during total intravenous anesthesia for suspension laryngoscopy using Analgesia/Nociception Index (ANI): a prospective observational study. Minerva Anestesiol. 2015;81(3):288–97.PubMed

Sabourdin N, Barrois J, Louvet N, Rigouzzo A, Guye ML, Dadure C, Constant I. Pupillometry-guided intraoperative remifentanil administration versus standard practice influences opioid use: a randomized study. Anesthesiology. 2017;127(2):284–92. https://doi.org/10.1097/ALN.0000000000001705.CrossRefPubMed

Jensen EW, Valencia JF, Lopez A, Anglada T, Agusti M, Ramos Y, Serra R, Jospin M, Pineda P, Gambus P. Monitoring hypnotic effect and nociception with two EEG-derived indices, qCON and qNOX, during general anaesthesia. Acta Anaesthesiol Scand. 2014;58(8):933–41. https://doi.org/10.1111/aas.12359.CrossRefPubMed

Rhudy JL, France CR. Defining the nociceptive flexion reflex (NFR) threshold in human participants: a comparison of different scoring criteria. Pain. 2007;128(3):244–53. https://doi.org/10.1016/j.pain.2006.09.024.CrossRefPubMed

10.

Jakuscheit A, Weth J, Lichtner G, Jurth C, Rehberg B, von Dincklage F. Intraoperative monitoring of analgesia using nociceptive reflexes correlates with delayed extubation and immediate postoperative pain: a prospective observational study. Eur J Anaesthesiol. 2017;34(5):297–305. https://doi.org/10.1097/EJA.0000000000000597.CrossRefPubMed

11.

Bergmann I, Gohner A, Crozier TA, Hesjedal B, Wiese CH, Popov AF, Bauer M, Hinz JM. Surgical pleth index-guided remifentanil administration reduces remifentanil and propofol consumption and shortens recovery times in outpatient anaesthesia. Br J Anaesth. 2013;110(4):622–8. https://doi.org/10.1093/bja/aes426.CrossRefPubMed

12.

Ledowski T, Ang B, Schmarbeck T, Rhodes J. Monitoring of sympathetic tone to assess postoperative pain: skin conductance vs surgical stress index. Anaesthesia. 2009;64(7):727–31. https://doi.org/10.1111/j.1365-2044.2008.05834.x.CrossRefPubMed

13.

Martini CH, Boon M, Broens SJ, Hekkelman EF, Oudhoff LA, Buddeke AW, Dahan A. Ability of the nociception level, a multiparameter composite of autonomic signals, to detect noxious stimuli during propofol-remifentanil anesthesia. Anesthesiology. 2015;123(3):524–34. https://doi.org/10.1097/ALN.0000000000000757.CrossRefPubMed

14.

Boselli E, Bouvet L, Begou G, Dabouz R, Davidson J, Deloste JY, Rahali N, Zadam A, Allaouchiche B. Prediction of immediate postoperative pain using the analgesia/nociception index: a prospective observational study. Br J Anaesth. 2014;112(4):715–21. https://doi.org/10.1093/bja/aet407.CrossRefPubMed

15.

Jeanne M, Clement C, De Jonckheere J, Logier R, Tavernier B. Variations of the analgesia nociception index during general anaesthesia for laparoscopic abdominal surgery. J Clin Monit Comput. 2012;26(4):289–94. https://doi.org/10.1007/s10877-012-9354-0.CrossRefPubMed

16.

Upton HD, Ludbrook GL, Wing A, Sleigh JW. Intraoperative "analgesia nociception index"-guided fentanyl administration during sevoflurane anesthesia in lumbar discectomy and laminectomy: a randomized clinical TRIAL. Anesth Analg. 2017;125(1):81–90. https://doi.org/10.1213/ANE.0000000000001984.CrossRefPubMed

17.

Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89–91. https://doi.org/10.1016/0952-8180(94)00001-k.CrossRefPubMed

18.

Gall O, Champigneulle B, Schweitzer B, Deram T, Maupain O, Montmayeur Verchere J, Orliaguet G. Postoperative pain assessment in children: a pilot study of the usefulness of the analgesia nociception index. Br J Anaesth. 2015;115(6):890–5. https://doi.org/10.1093/bja/aev361.CrossRefPubMed

19.

Gruenewald M, Ilies C, Herz J, Schoenherr T, Fudickar A, Hocker J, Bein B. Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol-remifentanil anaesthesia. Br J Anaesth. 2013;110(6):1024–30. https://doi.org/10.1093/bja/aet019.CrossRefPubMed

20.

Abad-Gurumeta A, Ripolles-Melchor J, Casans-Frances R, Calvo-Vecino JM. Monitoring of nociception, reality or fiction? Rev Esp de Anestesiol y Reanim. 2017;64(7):406–14. https://doi.org/10.1016/j.redar.2017.01.009.CrossRef

21.

Boselli E, Jacquet-Lagreze M, Ayoub JY, Bouvet L, Dauwalder O, Mansour C, Margez T, Paquet C, Restagno D, Allaouchiche B, Bonnet-Garin JM, Junot S. Effects of esmolol on systemic hemodynamics and heart rate variability measured using the analgesia/nociception index in resuscitated piglets with Pseudomonas aeruginosa septic shock. J Vet Emerg Crit Care. 2018;28(5):447–56. https://doi.org/10.1111/vec.12756.CrossRef

22.

Ramos-Luengo A, Asensio-Merino F. Hypnosis closed loop TCI systems in outpatient surgery. Rev Esp de Anestesiol y Reanim. 2017;64(6):323–7. https://doi.org/10.1016/j.redar.2016.10.005.CrossRef

23.

Boselli E, Daniela-Ionescu M, Begou G, Bouvet L, Dabouz R, Magnin C, Allaouchiche B. Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI). Br J Anaesth. 2013;111(3):453–9. https://doi.org/10.1093/bja/aet110.CrossRefPubMed

24.

Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118(4):934–44. https://doi.org/10.1097/ALN.0b013e31828866b3.CrossRefPubMed

25.

Daccache G, Caspersen E, Pegoix M, Monthe-Sagan K, Berger L, Fletcher D, Hanouz JL. A targeted remifentanil administration protocol based on the analgesia nociception index during vascular surgery. Anaesth Crit Care Pain Med. 2017;36(4):229–32. https://doi.org/10.1016/j.accpm.2016.08.006.CrossRefPubMed

26.

Meijer FS, Niesters M, van Velzen M, Martini CH, Olofsen E, Edry R, Sessler DI, van Dorp ELA, Dahan A, Boon M (2019) Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials. J Clin Monit Comput https://doi.org/10.1007/s10877-019-00362-4.CrossRefPubMedPubMedCentral

27.

Cao X, White PF, Ma H. An update on the management of postoperative nausea and vomiting. J Anesth. 2017;31(4):617–26. https://doi.org/10.1007/s00540-017-2363-x.CrossRefPubMed

Titel: Usefulness of ANI (analgesia nociception index) monitoring for outpatient saphenectomy surgery outcomes: an observational study
verfasst von: Adolfo Ramos-Luengo
Adela Gardeta Pallarés
Fernando Asensio Merino
Publikationsdatum: 28.02.2020
Verlag: Springer Netherlands
Erschienen in: Journal of Clinical Monitoring and Computing / Ausgabe 3/2021
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-020-00491-1

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Usefulness of ANI (analgesia nociception index) monitoring for outpatient saphenectomy surgery outcomes: an observational study

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