Validation of the PMD100 and its NOL Index to detect nociception at different infusion regimen of remifentanil in patients under general anesthesia

Minerva anestesiologica
Pierre-André StöcklePhilippe Richebé

Abstract

The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. The aim of this study was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anesthesia. A prospective, observational study at a single center (NCT02602379) included 40 ASA I to III patients undergoing laparotomy under remifentanil-desflurane anesthesia with epidural analgesia. A tetanic stimulation was applied (forearm) at remifentanil intravenous (IV) infusion of 0.005, 0.05, 0.1, and 0.15 µg/kg/min. NOL and its variations were compared with other parameters namely heart rate, mean arterial pressure, Bispectral Index, and Analgesia Nociception Index (ANI). Receiver operating characteristic (ROC) curves were plotted to assess the response to both intubation and standardized stimulus under remifentanil infusion of 0.005 µg/kg/min. The post-stimulation NOL values at remifentanil doses of 0.005, 0.05, 0.1 and 0.15 µg/kg/min (39 [23-55], 15 [7-30], 8 [4-14] and 8.5 [4-15]) were significantly higher than pre-stimulation counterparts (P<0.0001). For all other parameters, there was also significant difference between pre- and post-stimulat...Continue Reading

References

Aug 29, 2009·The Journal of Pain : Official Journal of the American Pain Society·Alban Latremoliere, Clifford J Woolf
Oct 6, 2011·Current Opinion in Anaesthesiology·Terri G Monk, B Craig Weldon
Jun 25, 2013·Pain·Ru-Rong JiMaiken Nedergaard
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Citations

Oct 11, 2019·Journal of Clinical Monitoring and Computing·Julien RaftPhilippe Richebe
Oct 28, 2019·Current Opinion in Anaesthesiology·Borzoo Farhang, Donald M Mathews
Jul 22, 2019·Journal of Clinical Monitoring and Computing·Fleur S MeijerMartijn Boon
Oct 3, 2018·Minerva anestesiologica·Manuel Á Gómez-RíosJosé M Calvo-Vecino
Jan 25, 2021·Journal of Clinical Monitoring and Computing·Thomas LedowskiNyomi Hall
Aug 24, 2021·Der Anaesthesist·Rainer NitzschkeSandra Funcke

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