Reyes-Hernández A, Márquez-Gutiérrez VJA, Athié-García JM

Language: Spanish
References: 16
Page: 151-157
PDF size: 316.79 Kb.

ABSTRACT

Introduction: monitoring nociception (activity of the sympathetic and/or parasympathetic nervous system as a reference for analgesia or pain) in surgery is essential for the patient's well-being during the intraoperative period. The analgesia-nociception index (ANI) is used when appropriate equipment is available; otherwise, the surgical plethysmographic index (SPI) is used. Objective: this study aimed to correlate nociception assessment using both indices nociception-analgesia during laparoscopic surgery with general anaesthesia. Material and methods: in a non-randomized, descriptive, observational cohort study with 30 patients undergoing intravenous anaesthesia, we employed nociception-analgesia indices and the surgical plethysmographic index. Analgesia adequacy was assessed, and both indices were statistically compared at critical surgical moments. Results: the study revealed no statistically significant correlation between the nociception-analgesia index and the surgical plethysmographic index (Rho = 0.0009, p = 0.85). Notably, the nociception-analgesia index exhibited better consistency with expected patient responses during critical surgery phases. However, 13.6% of measurements showed discordance. Conclusion: the study supports the preference for the nociception-analgesia index in clinical practice, underlining the need for meticulous assessment of nociception monitoring tools in perioperative care. This emphasizes the importance of patient safety and well-being throughout surgical procedures.

REFERENCES

1. Gruenewald M, Ilies C. Monitoring the nociception-anti-nociception balance. Vol. 27, Best Practice and Research: Clinical Anaesthesiology. Bailliere Tindall Ltd; 2013. p. 235-247.

2. Guignard B. Monitoring analgesia. Vol. 20, Best practice and research: clinical anaesthesiology. 2006. p. 161-180.

3. Arechiga G, Mille J, Ramírez A. Hiperalgesia inducida por opioides (HIO). Rev Mex Anestesiol. 2010;33:S26-S29.

4. Fletcher D. Farmacología de los opioides [Internet]. 2011. Available in: www.iuphar.org/

5. Ledowski T. Monitoring nociception-getting 'there yet' might be easier with a road map. Br J Anaesth. 2017;119:716-717.

6. Abad-Gurumeta A, Ripollés-Melchor J, Casans-Francés R, Calvo-Vecino JM. Monitorización de la nocicepción, ¿realidad o ficción? Rev Esp Anestesiol Reanim. 2017;64:406-414.

7. Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. Vol. 20, BJA Education. Elsevier Ltd; 2020. p. 321-328.

8. Funcke S, Sauerlaender S, Pinnschmidt HO, Saugel B, Bremer K, Reuter DA, et al. Validation of innovative techniques for monitoring nociception during general anesthesia: a clinical study using tetanic and intracutaneous electrical stimulation. Anesthesiology. 2017;127:272-283.

9. Meijer FS, Niesters M, van Velzen M, Martini CH, Olofsen E, Edry R, et al. Does nociception monitor-guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials. Vol. 34, Journal of Clinical Monitoring and Computing. Springer; 2020. p. 629-641.

10. Merino W, Caniuman M, Muñoz I, Oyarce C. Estimative pain measurement during perioperative period: a review of current available devices. Vol. 50, Revista Chilena de Anestesia. Sociedad de Anestesiología de Chile; 2021. p. 646-652.

11. Logier R, Jeanne M, Tavernier B. PhysioDoloris: a monitoring device for analgesia/nociception balance evaluation using heart rate variability analysis. Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:1194-1197.

12. Jeanne M, Clément C, De Jonckheere J, Logier R, Tavernier B. Variations of the analgesia nociception index during general anaesthesia for laparoscopic abdominal surgery. In: Journal of Clinical Monitoring and Computing. 2012. p. 289-294.

13. Dostalova V, Schreiberova J, Bartos M, Kukralova L, Dostal P. Surgical pleth index and analgesia nociception index for intraoperative analgesia in patients undergoing neurosurgical spinal procedures: a comparative randomized study. Minerva Anestesiol. 2019;85:1265-1272.

14. Absalom A, Mani V, De Smet T. Pharmacokinetic models for propofol-defining and illuminating the devil in the detail. Br J Anaesth. 2009;103:26-37.

15. Minto CF, Schnider TW, Egan TD, Youngs E, Lemmens HJ, Gambus PL, et al. Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. Anesthesiology. 1997;86:10-23.

16. Muthukalai S, Bansal S, Chakrabarti D, Umamaheswara Rao G. Reliability of analgesia nociception index (ANI) and surgical pleth index (SPI) during episodes of bleeding-A pilot study. Indian J Anaesth. 2022;66:505-510.