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

Ramos‐Luengo, Adolfo; Pallarés, Adela Gardeta; Merino, Fernando Asensio

doi:10.1007/s10877-020-00491-1

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…There are a few studies that evaluated post-operative outcomes in patients that had ANI-guided analgesia. An observational study by Ramos-Luengo et al found that patients whose ANI values were higher than 50 for at least 60% of the time under anesthesia had a significantly lower length of stay post-operatively ( 35 ). While this study didn't test whether an ANI-treated group had a lower length of stay compared to a control group, this study could suggest that ensuring ANI values stay above 50 for a significant amount of time intra-operatively can reduce a patient's length of stay.…”

Section: Ani In the Post-operative Settingmentioning

confidence: 99%

The validity and applications of the analgesia nociception index: a narrative review

Hum,

Christophides,

Jin

et al. 2023

Front. Surg.

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Pain refers to the subjective, unpleasant experience that is related to illness or injury. In contrast to pain, nociception refers to the physiological neural processing of noxious stimuli, such as intra-operative surgical stimuli. One novel device, the Analgesia Nociception Index (ANI), aims to objectively measure intra-operative nociception by analyzing the heart rate variability in patients undergoing surgery. Through this method of nociceptive monitoring, the ANI device aims to provide an objective, continuous evaluation of patient comfort levels and allow anesthesiologists to better manage surgical stress and patient analgesia, perhaps with even better efficacy than current practices used to assess nociception. Additionally, ANI may have clinical application in settings outside of the operating room, such as in the intensive care unit. In this narrative review, we compiled and summarized the findings of many studies that have investigated ANI's validity and applications in different clinical settings. Currently, the literature appears mostly supportive of ANI's ability to detect nociception in both surgical and non-surgical settings. However, the ability for ANI to provide clinical benefits, such as decreased intra-operative opioid use, post-operative opioid use, and post-operative pain compared to standard practices appear controversial. Because of the wide variety of methodology, clinical settings, patient populations, and limitations in these studies, more investigation of ANI is needed before any firm conclusions can be drawn on its clinical benefits.

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Section: Ani In the Post-operative Settingmentioning

confidence: 99%

The validity and applications of the analgesia nociception index: a narrative review

Hum,

Christophides,

Jin

et al. 2023

Front. Surg.

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“…Thus, further studies on the association between prognosis and ANI/HFVI in various population groups in ICU are necessary. In addition, a study monitoring ANI in one-day surgery reported that the group with ANI ≥ 50 for at least 60% of the time they were under anesthesia had a significantly shorter hospital stay than those with ANI < 50 [165 min (118–212) vs 186.5 min (119–254), p = 0.0425] [ 68 ]. As such, investigation of association between comprehensive outcomes following day surgery/anesthesia and ANI are also interesting.…”

Section: Outlooks Of Ani/hfvimentioning

confidence: 99%

Analgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone

2022

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At present, there is no objective and absolute measure of nociception, although various monitoring techniques have been developed. One such technique is the Analgesia Nociception Index (ANI), which is calculated from heart rate variability that reflects the relative parasympathetic tone. ANI is expressed on a non-unit scale of 0–100 (100 indicates maximal relative parasympathetic tone). Several studies indicated that ANI-guided anesthesia may help reduce intraoperative opioid use. The usefulness of ANI in the intensive care unit (ICU) and during surgery has also been reported. However, some limitations of ANI have also been reported; for example, ANI is affected by emotions and some drugs. In 2022, a high frequency variability index (HFVI), which was renamed from ANI and uses the same algorithm as ANI, was commercialized; therefore, ANI/HFVI are currently in the spotlight. Unlike ANI, HFVI can be displayed along with other biometric information on the Root ® monitor. ANI/HFVI monitoring may affect the prognosis of not only patients in the perioperative period but those in ICU, those who receive home medical care, or outpatients. In this article, we present an updated review on ANI that has been published in the last decade, introduce HFVI, and discuss the outlooks of ANI/HFVI.

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“…This heart-rate variability is supposed to mainly express the parasympathetic tone of the autonomous nervous system. 8 The Newborn Infant Parasympathetic Evaluation (NIPE) index using a similar approach for children was presented in 2018. Derived from a routine ECG, heart-rate variability is used to calculate a real-time index as a dimensionless numeric value from 0 to 100.…”

Section: Introductionmentioning

confidence: 99%

“…For example, in adolescents and adults, the Analgesia Nociception Index (ANI) monitor continuously records the electrocardiogram (ECG) signal and runs an algorithm on fluctuations of heart rate due to respiration and ventilation. This heart‐rate variability is supposed to mainly express the parasympathetic tone of the autonomous nervous system 8 . The Newborn Infant Parasympathetic Evaluation (NIPE) index using a similar approach for children was presented in 2018.…”

Section: Introductionmentioning

confidence: 99%

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

Babasiz

Straßberger‐Nerschbach

Schindler

et al. 2022

Pediatric Anesthesia

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Background: The validity of current tools for intraoperative objective assessment of nociception/antinociception balance during anesthesia in young and very young surgery children is unknown. Aim: Primary aim of the study was to test the hypothesis that the Newborn Infant Parasympathetic Evaluation (NIPE) index performs better in indicating nociception in anesthetized children below 2 years than changes in heart rate. Secondary aims were to evaluate associations between intraoperative changes in NIPE index values and postoperative pain and emergence delirium.

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

Cited by 5 publications

References 25 publications

The validity and applications of the analgesia nociception index: a narrative review

The validity and applications of the analgesia nociception index: a narrative review

Analgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone

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

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