A randomised controlled trial of the analgesia nociception index for intra‐operative remifentanil dose and pain after gynaecological laparotomy

Yoon, Hyun Kyu; Kim, Y J; Lee, H S; Seo, J-H; Kim, Hee-Soo

doi:10.1111/anae.16008

Cited by 5 publications

(1 citation statement)

References 37 publications

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“…Recent RCTs offer conflicting findings about ANI's impact on total opioid consumption: some report lower opioid use, others higher and some no significant difference. Postoperative pain scores, rescue medication, and adverse effect frequency remained unaffected in these studies [23–25,26 ▪▪ ]. In a meta-analysis by Kim et al , which included seven studies assessing intraoperative opioid use and ANI-guided analgesia with various drugs, overall consumption was lower in the ANI group.…”

Section: Resultsmentioning

confidence: 90%

Progress in the validation of nociception monitoring in guiding intraoperative analgesic therapy

Van Santvliet,

Vereecke

2024

Current Opinion in Anaesthesiology

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Purpose of review This article summarizes the current level of validation for several nociception monitors using a categorized validation process to facilitate the comparison of performance. Recent findings Nociception monitors improve the detection of a shift in the nociception and antinociception balance during anesthesia, guiding perioperative analgesic therapy. A clear overview and comparison of the validation process for these monitors is missing. Results Within a 2-year time-frame, we identified validation studies for four monitors [analgesia nociception index (ANI), nociception level monitor (NOL), surgical pleth index (SPI), and pupillometry]. We categorized these studies in one out of six mandatory validation steps: developmental studies, clinical validation studies, pharmacological validation studies, clinical utility studies, outcome improvement studies and economical evaluation studies. The current level of validation for most monitors is mainly focused on the first three categories, whereas ANI, NOL, and SPI advanced most in the availability of clinical utility studies and provide confirmation of a clinical outcome improvement. Analysis of economical value for public health effects is not yet publicly available for the studied monitors. Summary This review proposes a stepwise structure for validation of new monitoring technology, which facilitates comparison between the level of validation of different devices and identifies the need for future research questions.

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Section: Resultsmentioning

confidence: 90%

Progress in the validation of nociception monitoring in guiding intraoperative analgesic therapy

Van Santvliet,

Vereecke

2024

Current Opinion in Anaesthesiology

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Comparison of different monitors for measurement of nociception during general anaesthesia: a network meta-analysis of randomised controlled trials

Snoek,

van den Berg,

Dahan

et al. 2025

British Journal of Anaesthesia

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Effects of goal-directed analgesia using the analgesia nociception index in children undergoing surgery for moyamoya disease

Park,

Kang,

et al. 2024

European Journal of Anaesthesiology

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BACKGROUND The potential benefits of Analgesia Nociception Index guided intra-operative analgesia on intra-operative opioid consumption remains to be demonstrated in paediatric anaesthesia. OBJECTIVES This study aimed to explore the effects of Analgesia Nociception Index guided analgesia on sufentanil consumption during anaesthesia and postoperative pain scores in paediatric patients with moyamoya disease. DESIGN A prospective randomised controlled study. SETTING Seoul National University Children's Hospital, Seoul, Republic of Korea. PATIENTS A total of 40 children scheduled for encephaloduroarteriosynangiosis. MAIN OUTCOME MEASURES The primary outcome was total intra-operative sufentanil consumption, and the secondary outcomes included postoperative pain scores and incidence of opioid-related adverse events. RESULTS The Analgesia Nociception Index group showed lower intra-operative sufentanil consumption (in μg kg−1 h−1) compared with the Standard group (0.30 ± 0.12 and 0.39 ± 0.17, respectively; mean difference, –0.09; 95% confidence interval, –0.19 to 0.00; P = 0.049). Postoperatively, compared with the Standard group, the Analgesia Nociception Index group reported lower median pain scores at 18 and 24 h and maximum pain within 24 h (1 [0 to 2] vs. 3 [2 to 5]; P = 0.004, 1 [0 to 2] vs. 3 [1 to 4]; P = 0.041, and 4 [3 to 5] vs. 5 [4 to 7]; P = 0.045, respectively), with fewer patients experiencing nausea (3 [15%] vs. 10 [50%], P = 0.043). CONCLUSION The Analgesia Nociception Index guided analgesic protocol can reduce intra-operative sufentanil consumption and postoperative pain within 24 h with fewer nausea symptoms in paediatric patients with moyamoya disease who undergo encephaloduroarteriosynangiosis. TRIAL REGISTRATION NUMBER NCT05672212 (registered at clinicaltrials, principal investigator: K.E.H., registration date: 2 January 2023)

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A randomised controlled trial of the analgesia nociception index for intra‐operative remifentanil dose and pain after gynaecological laparotomy

Cited by 5 publications

References 37 publications

Progress in the validation of nociception monitoring in guiding intraoperative analgesic therapy

Progress in the validation of nociception monitoring in guiding intraoperative analgesic therapy

Comparison of different monitors for measurement of nociception during general anaesthesia: a network meta-analysis of randomised controlled trials

Effects of goal-directed analgesia using the analgesia nociception index in children undergoing surgery for moyamoya disease

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