Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children

British Journal of Anaesthesia
F Julien-MarsollierS Dahmani

Abstract

Intraoperative analgesia is still administered without guidance. Anaesthetists decide upon dosing on the basis of mean population opioid pharmacological studies and in response to variations in haemodynamic status. However, those techniques have been shown to be imprecise. We assessed the diagnostic value of monitoring the analgesia nociception index (ANI) to detect surgical stimulation in children. This was an observational study of 2- to 12-yr-old patients 5 min before and after surgical incision. Hypnosis was maintained with sevoflurane and guided by bispectral index. Intraoperative analgesia was administered as a remifentanil infusion titrated to variations in haemodynamic parameters, and ANI monitor values were recorded. ANI parameters assessed included instantaneous ANI (ANIi), mean ANI (ANIm), and the relative change of ANIi to ANIm (DeltaANI=ANIi-ANIm/ANIm). Statistical analyses were performed using receiver-operating-characteristic analysis with determination of the area under the receiver operating characteristic (AUROC) curve and the grey zone. Overall, 49 subjects were included in this study. The AUROC was 0.755 (0.738-0.772), 0.771 (0.755-0.787), and 0.756 (0.738-0.774) for ANIi, ANIm, and DeltaANI, respectively. T...Continue Reading

Associated Clinical Trials

Citations

Oct 28, 2019·Current Opinion in Anaesthesiology·Borzoo Farhang, Donald M Mathews
Mar 21, 2019·Current Opinion in Anaesthesiology·Andrew Davidson, Justin Skowno
Mar 17, 2020·Computers in Biology and Medicine·José M Gonzalez-CavaJuan Albino Mendez-Perez
Oct 3, 2021·NeoReviews·Wojciech WalasAndrzej Piotrowski

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