Effect of postoperative peripheral nerve blocks on the analgesia nociception index under propofol anesthesia: an observational study

Journal of Clinical Monitoring and Computing, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 29, 2025

The analgesia nociception index (ANI), also referred to as the high frequency variability (HFVI), is reported be an objective measure of nociception. This study investigated changes in ANI after peripheral nerve blocks (PNB) under general anesthesia. Understanding these could enhance assessment PNB efficacy before emergence from enrolled 30 patients undergoing elective upper limb surgery. After surgery, median and maximum values were recorded during two periods: a 5-minute period 20-minute PNB. numeric rating scale (NRS) for pain was assessed twice: immediately anesthesia (N1) experienced by following morning effects subsided (N2). difference tested using Wilcoxon signed-rank test. Statistical significance set at P < 0.05. significantly increased both (pre vs. post value: 53.5 [44.0–68.0] 59.0 [47.0-78.3], [interquartile range]; 0.05) (64.0 [56.3–79.5] 74.5 [61.5–85.3]; 0.01). Secondary analysis revealed that significant increases (48.0 [42.3–66.5] 61.0 [50.0-76.5]; 0.01) (58.5 [50.3–75.3] 76.0 [71.8–83.5]; 18 cases with N2 ≥ 4 whereas no statistical differences observed 12 4. value propofol may valuable indicator assessing efficacy. UMIN000050334. February 28, 2023.

Language: Английский

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Can Opioid-Free Anaesthesia Be Personalised? A Narrative Review

Journal of Personalized Medicine, Journal Year: 2023, Volume and Issue: 13(3), P. 500 - 500

Published: March 10, 2023

Background: A significant amount of evidence suggests that Opioid-Free Anaesthesia (OFA) may provide better outcomes for patients undergoing surgery, sparing who are particularly vulnerable to adverse side effects opioids. However, what extent personalizing OFA is feasible and beneficial has not been adequately described. Methods: We conducted a narrative literature review aiming comprehensive understanding nociception pain its context within the field OFA. Physiological (including monitoring), pharmacological, procedural (type surgery), genetical phenotypical patients’ conditions) were considered. Results: did find any monitoring robustly associated with improved outcomes. we found supporting particular indications, such as bariatric cancer surgery. benefit more from OFA, an interesting research in suffering vascular disease. variety techniques medications making it impossible consider single technique. Our findings suggest vast remains unexplored. In particular, deeper interest genetic acquired contributors would be excellent starting point paving way personalised Conclusion: Recent developments present holistic approach, challenging use Understanding nociception, given techniques, help maximize their potential different contexts indications.

Language: Английский

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Hypnotic Modulation of Autonomic Nervous System (ANS) Activity

Brain Sciences, Journal Year: 2024, Volume and Issue: 14(3), P. 249 - 249

Published: March 4, 2024

Hypnosis, a time-honored therapeutic approach, has gained widespread recognition for its effectiveness in addressing range of psychological and somatic disorders. While primary effects are mediated by central top–down mechanisms, hypnosis also exerts peripheral influence modulating the autonomic nervous system (ANS). Psychophysiological measures, such as heart rate (HR) variability (HRV), electrodermal activity (EDA), respiratory (RR), analgesia nociceptive index (ANI), serve reliable indicators ANS activity. Studies have consistently demonstrated hypnosis’ ability to significantly impact functions, lowering sympathetic enhancing parasympathetic tone. This effect is particularly pronounced during relaxation procedures influenced mediating factors like hypnotizability task conditions. Despite methodological limitations, this review highlights potential enhanced modulation through hypnosis, including connections (CNS), optimize outcomes patients with psychosomatic disorders associated dysfunction.

Language: Английский

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Machine learning model of facial expression outperforms models using analgesia nociception index and vital signs to predict postoperative pain intensity: a pilot study

Korean journal of anesthesiology, Journal Year: 2024, Volume and Issue: 77(2), P. 195 - 204

Published: Jan. 5, 2024

Few studies have evaluated the use of automated artificial intelligence (AI)-based pain recognition in postoperative settings or correlation with intensity. In this study, various machine learning (ML)-based models using facial expressions, analgesia nociception index (ANI), and vital signs were developed to predict intensity, their performances for predicting severe compared.

Language: Английский

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Opioid-Free Anesthesia in Bariatric Surgery: Is It the One and Only? A Comprehensive Review of the Current Literature

Healthcare, Journal Year: 2024, Volume and Issue: 12(11), P. 1094 - 1094

Published: May 27, 2024

Opioid-free anesthesia (OFA) is a heterogeneous group of general techniques in which the intraoperative use opioids eliminated. This strategy aims to decrease risk complications and improve patient's safety comfort. Such potential advantages are particularly beneficial for selected groups patients, among them obese patients undergoing laparoscopic bariatric surgery. Opioids have been traditionally used as an element balanced anesthesia, replacing requires using combination coanalgesics various types local regional also their side effects, limitations, disadvantages. Moreover, despite growing amount evidence, empirical data on superiority OFA compared standard with multimodal analgesia contradictory, benefits many studies being questioned. Additionally, little known about long-term sequelae such strategy. Considering above-mentioned issues, this study present benefits, risks, difficulties implementing surgery, considering current state knowledge literature.

Language: Английский

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Analgesia Nociception Index Monitoring in Management of Perioperative Analgesia in Total Knee Arthroplasty Surgeries with Femoral Nerve Block

Medicina, Journal Year: 2025, Volume and Issue: 61(2), P. 213 - 213

Published: Jan. 25, 2025

Background and Objectives: The aim of our study is to determine the effects analgesia nociception index (ANI) monitoring on intraoperative opioid consumption, postoperative analgesia, recovery unit length stay in patients with a preoperative femoral nerve block (FNB) undergoing total knee arthroplasty (TKA) surgery under general anesthesia. Materials Methods: Seventy-four American Society Anesthesiologists Physical Status (ASA-PS) I-III scheduled for TKA anesthesia were included this study. After FNB, divided into two groups (control group (n = 35)–ANI 35)). standard induction both groups, maintenance was conducted using sevoflurane remifentanil infusion bispectral (BIS) between 40 60. In control group, dose adjusted conventional methods, ANI values 50–70. duration operation, surgery, extubation time, tourniquet pressure, amount consumed intraoperatively recorded. Results: Intraoperative consumption lower compared (p 0.001). time reach Modified Aldrete Scale score (MAS) ≥ 9 shorter < NRS scores 4, 8, 12, 24 h postoperatively 0.006, p 0.05). There weak significant inverse relationship last measured before (r: −0.070–0.079, p: 0.698–0.661). No difference observed other data. Conclusions: FNB anesthesia, decreased opioids pain shortened unit. We suggest that management may be helpful determining needed by patient individualized management.

Language: Английский

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The perioperative analgesic effects of thoracolumbar interfacial block and erector spinae plane block for open lumbar fusion: a randomized controlled trial

Annals of critical care, Journal Year: 2025, Volume and Issue: 1, P. 101 - 109

Published: Jan. 31, 2025

OBJECTIVE: The purpose of this study is to compare the pain reduction effectiveness thoracolumbar interfascial plane (TLIP) block with erector spinae (ESP) for open lumbar fusion. MATERIALS AND METHODS: From October 2021 2022, 100 patients participated in a randomized prospective intervention at Hanoi Medical University Hospital. were randomly assigned three groups: control group (group C, n = 33), TLIP T, 34), and ESP E, 33). status groups was assessed using intraoperative mean Analgesia Nociception Index (ANIm), postoperative Numerical Rating Scale (NRS) rest on movement 1, 2, 4, 8, 12, 24 hour safter surgery. fentanyl morphine consumption 12 postoperatively recorded. RESULTS: ANIm C lowest most time points studied during surgery (p < 0.05). Group E consumed least intraoperatively 0.001). NRS highest At hours following surgery, E's initial mobilization hospital stay 0.001 p 0.039, respectively). CONCLUSIONS: both provide good relief after However, more successful than relieving perioperative pain.

Language: Английский

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Effect of opioid titration protocol using nociception monitors in gynecologic laparoscopic surgery with total hysterectomy: A randomized controlled trial (OPTIMIST-h study)

Medicine Case Reports and Study Protocols, Journal Year: 2025, Volume and Issue: 6(2), P. e00354 - e00354

Published: March 24, 2025

Study objective: This study aims to assess the importance of administering opioids appropriately based on nociceptive monitoring. Design: Randomized controlled trial. Setting: Single center, operating room. Patients: The will include 75 patients scheduled undergo a robot-assisted or total laparoscopic hysterectomy (TLH). Interventions: Patients be allocated randomly receive nociception level-directed intraoperative opioid management, high-frequency variability index-directed conventional analgesic management (control group). Measurements: primary outcome mean remifentanil infusion flow rate (intraoperative usage [μg] divided by ideal body weight [kg] and operation time [min]). secondary outcomes plasma concentrations 3 perioperative inflammatory biomarkers (interleukin-6, C-reactive protein, cortisol), Quality Recovery-15 scores (preoperative postoperative days 1 2), fentanyl consumption, pain (numeric rating scale) (2 hours postoperatively 1, 2, 3), presence chronic postsurgical pain. Main results: We expect that in intervention groups have reduced without worsening markers, numeric scale scores, compared with those control group. results this may provide important insights into dose-adjustment strategies using monitors TLH. Conclusion: trial evaluate effects monitor-directed investigate levels interleukin-6, cortisol, protein. In addition, is expected compare monitors, including sedation combined

Language: Английский

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Balancing autonomic nervous system activity through hypnosis clinical implications for pain therapy

Published: April 25, 2025

Hypnosis, a clinically valuable therapeutic modality, is increasingly recognized for its efficacy in treating spectrum of psychological and somatic disorders, including pain. Its influence extends beyond central nervous system processes to encompass the autonomic (ANS), thereby affecting peripheral physiological responses. Objective psychophysiological measures, heart rate (HR), variability (HRV), electrodermal activity (EDA), Analgesia Nociceptive Index (ANI), provide quantifiable evidence ANS modulation. Studies consistently demonstrate that hypnosis promotes shift towards parasympathetic dominance, characterized by reduced sympathetic enhanced tone, particularly during relaxation protocols. This effect subject individual differences hypnotizability specific task conditions. While acknowledging methodological considerations, this mini review highlights promising role targeted modulation through optimizing interventions pain disorders associated with dysregulation.

Language: Английский

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Clinical efficacy and safety of automatic remifentanil administration based on Analgesia Nociception Index monitoring during burn surgery under propofol anesthesia: A randomized controlled clinical trial

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(5), P. e0322384 - e0322384

Published: May 5, 2025

Background Monitoring the nociception/antinociception balance for analgesic guidance during general anesthesia may improve quality of anesthesia. The University Hospital Lille (France) has developed an expert software system automatic remifentanil administration based on continuous monitoring Analgesia Nociception Index (MDoloris, France). We assessed clinical efficacy and safety ANI-REMI-LOOP “expert-system software” burn surgery in a monocentric randomized controlled trial. Methods trial was approved by French Ethics Committee, all patients gave written informed consent. From 2018 to 2022, 52 adults were into two groups: manual infusion (standard practice) or (expert-system software) BIS-guided propofol at center hospital. In standard practice group, Minto’s model guided analgesia nociception index. both groups, administered Schnider’s BiSpectral (Covidien). primary endpoint cumulative dose secondary endpoints related with incidence duration hypotension, bradycardia, hypertension tachycardia nociception. After anesthesia, pain requirements 2 hours. A p value < 0.05 considered statistically significant. Data are presented as median [1 st 3 rd quartile]. Results significantly lower group 0.125 µg.kg -1 .min [0.106 0.149] vs. 0.152 [0.137 0.237], = 0.004), proportion time hemodynamic impairment reactivity expert-system 4.2% [2.5 5.7] 19.4% [6.9 59.9], 0.010). There no issues, similar groups after surgery. Conclusions Automatic demonstrated good performances It is likely that these results can be extrapolated any surgical setting under but this needs tested further trials.

Language: Английский

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