• Guldem Turan, Ar Arzu Yıldırım AY Fatih Sultan Mehmet Teaching and Research Hospital, Anesthesiology and Intensive Care Unit, Istanbul, Turquia., Yıldız Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, and Erhan Celikoglu.
• Fatih Sultan Mehmet Teaching and Research Hospital, Anesthesiology and Intensive Care Unit, Istanbul, Turquia. Electronic address: gturanmd@yahoo.com.
• Rev Bras Anestesiol. 2017 Jul 1; 67 (4): 370-375.

Background And ObjectivesThe Analgesia Nociception Index is an index used to measure the levels of pain, sympathetic system activity and heart rate variability during general anesthesia. In our study, Analgesia Nociception Index monitoring in two groups who had undergone spinal stabilization surgery and were administered propofol-remifentanil (Total Intravenous Anesthesia) and sevoflurane-remifentanyl anesthesia was compared regarding its significance for prediction of postoperative early pain.MethodsBIS and Analgesia Nociception Index monitoring were conducted in the patients together with standard monitoring. During induction, fentanyl 2μg.kg-1, propofol 2.5mg.kg-1 and rocuronium 0.6mg.kg-1 were administered. During maintenance, 1.0 MAC sevoflurane+remifentanil 0.05-0.3μg.kg-1.min-1 and propofol 50-150μg.kg-1.min+remifentanil 0.05-0.3μg.kg-1.min-1 were administered in Group S and Group T, respectively. Hemodynamic parameters, BIS and Analgesia Nociception Index values were recorded during surgery and 30min postoperatively. Postoperative visual analog scale (VAS) values at 30minutes were recorded.ResultsWhile no difference was found between mean Analgesia Nociception Index at all times of measurement in both groups, Analgesia Nociception Index measurements after administration of perioperative analgesic drug were recorded to be significantly higher compared to baseline values in both groups. There was correlation between mean values of Analgesia Nociception Index and VAS after anesthesia.ConclusionAnalgesia Nociception Index is a valuable parameter for monitoring of perioperative and postoperative analgesia. In spine surgery, similar analgesia can be provided in both Total Intravenous Anesthesia with remifentanil and sevoflurane administration. Analgesia Nociception Index is efficient for prediction of the need for analgesia during the early postoperative period, and therefore is the provision of patient comfort.Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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