The predictive value of the heart rate variability-derived Analgesia Nociception Index in children anaesthetized with sevoflurane: An observational pilot study

European Journal of Pain : EJP
F WeberC A Liebrand

Abstract

The heart rate variability (HRV)-derived Analgesia Nociception Index (ANI™) is a continuous noninvasive tool to assess the nociception/antinociception balance in unconscious patients. It has been shown to be superior to haemodynamic variables in detecting insufficient antinociception in children, while little is known about its predictive value. The primary objective of this prospective observational pilot study in paediatric surgical patients under sevoflurane anaesthesia was to compare the predictive value of the ANI and heart rate to help decide to give additional opioids. The paediatric anaesthesiologist in charge was blinded to ANI values. In patients with an ANI value <50 (indicating insufficient antinociception) at the moment of decision, ANI values dropped from ±55 (indicating sufficient antinociception) to ±35, starting 60 s before decision. Within 120 s after administration of fentanyl (1 μg/kg), ANI values returned to ±60. This phenomenon was only observed in the ANI values derived from HRV data averaged over 2 min. Heart rate remained unchanged. In patients with ANI values ≥50 at the time of decision, opioid administration had no effect on ANI or heart rate. The same accounts for morphine for postoperative analgesia...Continue Reading

References

Mar 29, 2012·Journal of Clinical Monitoring and Computing·M JeanneB Tavernier
Sep 10, 2013·Best Practice & Research. Clinical Anaesthesiology·Matthias Gruenewald, Christoph Ilies
Feb 15, 2014·The Clinical Journal of Pain·Mathieu JeanneBenoît Tavernier
Jun 3, 2017·Frontiers in Physiology·Waldemar BobkowskiPrzemyslaw Guzik
Jun 20, 2017·Anesthesia and Analgesia·Georges DaccacheDominique Fletcher

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Citations

Oct 28, 2019·Current Opinion in Anaesthesiology·Borzoo Farhang, Donald M Mathews
Jan 12, 2019·Anesthesia and Analgesia·A Y Rosalie KühlmannMonique van Dijk
Mar 21, 2019·Current Opinion in Anaesthesiology·Andrew Davidson, Justin Skowno
Oct 3, 2021·NeoReviews·Wojciech WalasAndrzej Piotrowski

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