Comparison of the Newborn Infant Parasympathetic Evaluation (<scp>NIPE™</scp>) index to changes in heart rate to detect intraoperative nociceptive stimuli in healthy and critically ill children below 2 years: An observational study

Babasiz, Tamara; Straßberger‐Nerschbach, Nadine; Schindler, Ehrenfried; Reuter, Christian; Weinhold, Leonie; Wittmann, Mária; Hilbert, Tobias; Klaschik, Sven

doi:10.1111/pan.14446

Cited by 13 publications

(3 citation statements)

References 27 publications

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“…However, other studies found no correlation with pain scores ( 45 , 46 ). Moreover, the reported diagnostic performance varied considerably between studies, with the AUC ranging from 0.56 to 0.93 ( 41 , 42 , 44 , 46 – 48 ). NIPE generally performed better in neonates with higher levels of pain compared with those with mild pain.…”

Section: Monitoring- and Response-biomarkersmentioning

confidence: 99%

Biomarkers for assessing pain and pain relief in the neonatal intensive care unit

ten Barge,

Baudat,

Meesters

et al. 2024

Front. Pain Res.

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Newborns admitted to the neonatal intensive care unit (NICU) regularly undergo painful procedures and may face various painful conditions such as postoperative pain. Optimal management of pain in these vulnerable preterm and term born neonates is crucial to ensure their comfort and prevent negative consequences of neonatal pain. This entails accurate and timely identification of pain, non-pharmacological pain treatment and if needed administration of analgesic therapy, evaluation of treatment effectiveness, and monitoring of adverse effects. Despite the widely recognized importance of pain management, pain assessment in neonates has thus far proven to be a challenge. As self-report, the gold standard for pain assessment, is not possible in neonates, other methods are needed. Several observational pain scales have been developed, but these often rely on snapshot and largely subjective observations and may fail to capture pain in certain conditions. Incorporation of biomarkers alongside observational pain scores holds promise in enhancing pain assessment and, by extension, optimizing pain treatment and neonatal outcomes. This review explores the possibilities of integrating biomarkers in pain assessment in the NICU.

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Section: Monitoring- and Response-biomarkersmentioning

confidence: 99%

Biomarkers for assessing pain and pain relief in the neonatal intensive care unit

ten Barge,

Baudat,

Meesters

et al. 2024

Front. Pain Res.

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“…More recently, a 15–30% decrease in NIPE values has shown a sensitivity of 92% and a specificity of 96% for nociception during venous puncture, surgical skin incision and intubation [ 39 ]. In 2-year-old children undergoing brief tetanic stimulations (5 s, 100 Hz, 10 to 60 mA), NIPE proportionally decreased from a baseline of 75 ± 10 to 48 ± 12 (60 mA), whereas heart rate changed minimally [ 40 ].…”

Section: Nociception Monitorsmentioning

confidence: 99%

Evaluation of Nociception during Pediatric Surgery: A Topical Review

Bertolizio

Garbin

Ingelmo

2023

JPM

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The association between intraoperative nociception and increased patient’s morbidity is well established. However, hemodynamic parameters, such as heart rate and blood pressure, may result in an inadequate monitor of nociception during surgery. Over the last two decades, different devices have been marketed to “reliably” detect intraoperative nociception. Since the direct measure of nociception is impractical during surgery, these monitors measures nociception surrogates such as sympathetic and parasympathetic nervous systems responses (heart rate variability, pupillometry, skin conductance), electroencephalographic changes, and muscular reflex arc. Each monitor carries its own advantages and disadvantages. The manuscript aims to give an overview of the most up-to-date information available in the literature on current nociceptor monitors available in clinical practice, with particular focus on their applications in pediatrics.

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“…Pain, as defined by the International Association for the Study of Pain, is dependent on an individual’s conscious experience (https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/). Therefore, while nociception is a physiologic phenomenon that may be assessed objectively with NIPE and ANI, although seconds to minutes behind,10 pain is intrinsically subjective. In addition, intraoperative neuroendocrine responses may not necessarily be a function of nociception or predict postoperative pain.…”

Section: Advances In Monitoring or Advances In Carementioning

confidence: 99%