Recording rates of high-frequency variability index monitoring and use of vasoactive medications in daily clinical practice: A prospective observational study

Indian Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: 69(6), P. 615 - 620

Published: May 14, 2025

Background and Aims: To assess data recording rates of the high-frequency variability index (HFVI), which becomes less reliable with vasoactive medication use, examine use medications in daily clinical practice. The hypothesis is that when an HFVI sensor applied anaesthesia management left to discretion anaesthesiologist charge, interpretation would be limited. Methods: Patients aged ≥65 years who underwent elective major abdominal surgery for malignant disease under general those scheduled >2 h were eligible. anaesthesiologists managed patients sensors attached at their discretion, without any limitations on use. primary outcome was data-recording rate. Secondary outcomes intraoperative bolus continuous (ephedrine, phenylephrine, atropine, noradrenaline). percentage administration time calculated by dividing total time. Results: Of 249 eligible patients, successfully a mean rate 73.1% (95% confidence interval: 70.5%, 5.7%). Two hundred ten received least one during assessment period, ephedrine dominant. Sixty-one phenylephrine noradrenaline, ratios surgical 77.8% 84.9%, respectively. Conclusion: routine practice approximately 70%, many given medications; thus, caution must taken interpreting

Language: Английский

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The validity and applications of the analgesia nociception index: a narrative review

Frontiers in Surgery, Journal Year: 2023, Volume and Issue: 10

Published: Aug. 10, 2023

Pain refers to the subjective, unpleasant experience that is related illness or injury. In contrast pain, nociception physiological neural processing of noxious stimuli, such as intra-operative surgical stimuli. One novel device, Analgesia Nociception Index (ANI), aims objectively measure by analyzing heart rate variability in patients undergoing surgery. Through this method nociceptive monitoring, ANI device provide an objective, continuous evaluation patient comfort levels and allow anesthesiologists better manage stress analgesia, perhaps with even efficacy than current practices used assess nociception. Additionally, may have clinical application settings outside operating room, intensive care unit. narrative review, we compiled summarized findings many studies investigated ANI's validity applications different settings. Currently, literature appears mostly supportive ability detect both non-surgical However, for benefits, decreased opioid use, post-operative pain compared standard appear controversial. Because wide variety methodology, settings, populations, limitations these studies, more investigation needed before any firm conclusions can be drawn on its benefits.

Language: Английский

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Use of Infrared Thermography and Heart Rate Variability to Evaluate Autonomic Activity in Domestic Animals

Animals, Journal Year: 2024, Volume and Issue: 14(9), P. 1366 - 1366

Published: May 1, 2024

Most of the responses present in animals when exposed to stressors are mediated by autonomic nervous system. The sympathetic system, known as one responsible for “fight or flight” reaction, triggers cardiovascular changes such tachycardia vasomotor alterations restore homeostasis. Increase body temperature stressed also activates peripheral compensatory mechanisms cutaneous vasodilation increase heat exchange. Since skin blood flow influence amount dissipation, infrared thermography is suggested a tool that can detect said changes. review aims analyze application method assess stress-related activity, and their association with heart rate variability domestic animals.

Language: Английский

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Interference with high-frequency variability index

Journal of Anesthesia, Journal Year: 2023, Volume and Issue: 38(4), P. 563 - 564

Published: Aug. 18, 2023

Language: Английский

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The Performance of Using the Parasympathetic Tone Activity (PTA) Index to Assess Intraoperative Nociception in Cats

Veterinary Sciences, Journal Year: 2024, Volume and Issue: 11(3), P. 121 - 121

Published: March 6, 2024

The monitoring of nociception/antinociception poses a significant challenge during anesthesia, making the incorporation new tools like Parasympathetic Tone Activity (PTA) monitor an added value in feline anesthesia.

Language: Английский

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High frequency variability index in predicting postoperative pain in video/robotic-assisted thoracoscopic surgery under combined general anesthesia and peripheral nerve block: an observational study

Journal of Clinical Monitoring and Computing, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 20, 2024

Language: Английский

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BEHAVIORAL PAIN SCALES, VITAL SIGNS, AND PUPILOMETRY TO PAIN ASSESSMENT IN THE CRITICALLY ILL PATIENT: A CROSS SECTIONAL STUDY

Clinical Neurology and Neurosurgery, Journal Year: 2024, Volume and Issue: 247, P. 108644 - 108644

Published: Nov. 18, 2024

Language: Английский

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Predicting and evaluating pain after surgery…Newer methods to the rescue?

Indian Journal of Anaesthesia, Journal Year: 2023, Volume and Issue: 67(Suppl 2), P. S77 - S80

Published: Feb. 1, 2023

Managing post-surgical pain (PSP) is an integral part of anaesthesia practice; however, inspite significant advancements in peri-operative medicine and the introduction evidence-based recommendations for PSP management, existing data suggest that it sub-optimally managed.[1–3] The clinical prevalence acute as high 80%, one to 2/3 patients suffer moderate severe pain. This hampers early recovery, lengthens hospital stay, increases opioid consumption, leads persistent (PPSP).[3] PPSP observed 5–60% irrespective type surgery can be sufficient severity affect quality life.[4] Also, mentioned a previous editorial Indian Journal Anaesthesia (IJA), management practices our country are diverse.[5] All this leaves wondering whether current optimal. Are we really able accurately evaluate pain? How far have been successful predicting post-operative Currently, risk prediction models including biomarkers cyanosure researchers clinicians.[6] In era big data, events predicted. Can same performed successfully practice? CURRENT PERI-OPERATIVE PAIN PRACTICE PATTERNS Most literature agrees currently used multi-modal strategies prevent or manage seem insufficient, mostly because lack focus on organised approaches identify assure patient-specific management.[2] strategy most hospitals includes fixed prescription with additional analgesic according World health Organization (WHO) ladder reduce subjective scores. WHO which basically developed cancer tends worsen time relies heavily opioids. Analgesic administration per scores numerical rating scale (NRS) visual analogue (VAS), widely assessment tool, may lead over-use opioids interpret levels differently. Hence, rather than utilising NRS/VAS guide practices, application surgery-specific form regional analgesia closer site operation, psychological physical therapy, patient-controlled analgesia, oral opioid-sparing immediate release formulation advocated.[4] Besides these, high-quality complex task requiring multiple care personnel facilities along guidelines. Patient satisfaction not solely dependent upon intensity pain, indicators do play role patient satisfaction. Some paradoxically report level control despite might greater participation his/her treatment plan, adequate facilities, caring environment.[3] Nevertheless, good comfort, satisfaction, functional outcomes, life goals drive care.[7–9] means addition recovery too needs assessed. randomised controlled trial being published issue IJA, effect bolus intravenous lignocaine (1.5 mg/kg at induction followed by infusion 1 mg/kg/h 24 hours) relief has evaluated assessing Quality Recovery 15 (QoR15) score day suture removal undergoing breast cancer. authors found was better attributed lower consumption produced lignocaine.[10] clearly endorses use non-opioids management.[11] no longer novel now favourite both clinicians.[12] POST-OPERATIVE ASSESSMENT TOOLS Effective depends accurate assessment. There various frequently tools such VAS, NRS, verbal (VRS), faces (FPS). them uni-dimensional self-reported assess only intensity.[13] find difficulty describing complexity their single value descriptive words. subjectivity thus limitation, search objective goes on. article changes pupillary diameter were objectively mean showed incremental trend increasing VAS correlated well VAS.[14] trajectory more precise tool measurement dynamically accurately, where initial characterised through intercept, whereas resolution presented slope.[15] advantageous individualised focuses rapid resolution, reduction intensity. It noted since long helpful relieving suffering reducing magnitude surgical stress cost overuse but promote recovery.[4] Despite insight, routine scoring validated adopted. Various Clinically Aligned Pain Assessment (CAPA) Activity-Based Checks (ABCs) scale, 8-point recommended American Society, 3-point activity Scott McDonald already available.[4,16] These mood, movement, sleep control, side effects.[17] PRE-OPERATIVE PREDICTORS FOR ACUTE AND CHRONIC POST-SURGICAL evidence improving strongly timely identification, quantification, prevention its predictors. Many multi-centric studies identified characteristics (young age, female gender, obesity), pre-operative psychology (anxiety, depression), pre-existing status [severity, duration, disability, morphine milligram equivalent (MME) consumption], wound size >10 cm, predictors chronic PSP.[1,2,18,19] severity.[20] With growing technology medical science, health-related available stored systems, mobile applications wearables, artificial intelligence (AI), machine learning (ML) boon availability sets, fast analysis predictive algorithms, software helps physician understanding, predicting, managing also research.[21–25] sensitivity facial expression-based AI detect NRS ≥4/10 ≥7/10 using nurses (89.7% 77.5% versus 44.9% 17.0%, respectively).[25] Painchek smartphone-integrated automation AI-based based recognition expression who unable communicate during evaluation beneficial classifying, diagnosing, personalised patterns missed methods.[26,27] DEVELOPMENT OF BETTER PREDICTION EVALUATION MODELS As significantly subjective, gold standard remained patient-reported till now.[28] Self-reporting measures grossly misses cognitive domains Although self-reporting researched clinically used, thoroughly addressed limitations. Therefore, there continued need further research these aspects.[29] Such improve adapt develop validate sensor-based Whereas few tools, is, geriatric measure, brief inventory, composite index, so on, multi-dimensions beyond assessment, ample scope improve, shorten, different age groups, languages, cultures, ethnicity.[30] Technologies sense, map (neuroimaging), analyse evaluating biological, environmental, neuronal pathways developed. monitoring device, PMD-200 TM (Medasense Biometric Ltd. Ramat Gan, Israel), uses Nociception Level (NOL) measure response stimulus displays scale. intra-operatively shown inhalational agents, extubation.[31,32] However, efficacy reliability still matter research, especially post-anaesthesia unit ward awake. Ongoing (NCT03276260) enlighten us, will require validation from sub-groups centres across globe. some other nociception-based devices technologies well, Surgical Pleth Index (GE Healthcare, Helsinki, Finland),[33] Analgesia Index, recently renamed High-frequency Heart Rate Variability (Mdoloris Medical Systems, Loos, France), on.[34] tested anaesthetised awake when emotions spatial factors contribute Meanwhile, innovative continues take place, certain days come, anaesthesiologist equipped predict intra-operative outcomes well.

Language: Английский

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Evaluation of the effectiveness of analgesia nociception index (ANI) predictability for surgical stimuli under personal analgesic sufficiency status (PASS) measured by pre-tetanus-induced ANI: a pilot study

Journal of Clinical Monitoring and Computing, Journal Year: 2023, Volume and Issue: 37(6), P. 1585 - 1591

Published: July 7, 2023

Language: Английский

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Multimodal monitoring using the Analgesia Nociception Index (ANI) during catheter ablation of the heart in patients with sinus rhythm and short-term induced atrial arrhythmia: prospective observational study

Annals of critical care, Journal Year: 2024, Volume and Issue: 2, P. 159 - 171

Published: April 27, 2024

INTRODUCTION: Сatheter ablation (CA) is a painful procedure requiring an assessment of the balance between nociception associated with surgical trauma and anesthesia induced antinociception. OBJECTIVE: To evaluate effectiveness monitoring system “ANI Monitor” for intensive care in patients sinus rhythm short-term (< 1 min) atrial arrhythmia (STIAA). MATERIALS AND METHODS: The study group our trial consisted 94 CA ANI Monitor. control patients, selected using “copy-pair” method, standard (hemodynamic) monitoring. A Numerical Rating Scale (NRS) was used intensity pain. At stage femoral vein catheterization all regional performed, at stage, procedural sedation and/or analgesia (PSA) titrated administration propofol fentanyl (under Monitor). Statistical data processing carried out Statistica 10.0 SPSS programs. RESULTS: under PSA, negative correlation found NRS ANIm STIAA (r = −0.37). threshold 56.0 sensitivity specificity detecting ˃ 3 were 60 100 %, respectively, corresponding to ROC curve AUC 0.81. Significant changes hemodynamic reactivity not registered. It revealed reduction (0.04 ± 0.02 0.05 0.03 µg/kg/min, p < 0.001) CONCLUSIONS: Monitor during more effective harmful nociceptive stimuli compared use could create conditions opioid-sparing anesthesia.

Language: Английский

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