• Br J Anaesth · Aug 2018

    Observational Study

    Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children.

    • F Julien-Marsollier, K Rachdi, M-J Caballero, F Ayanmanesh, T Vacher, A-L Horlin, A Skhiri, C Brasher, D Michelet, and S Dahmani.
    • Department of Anaesthesia and Intensive Care, Robert Debré University Hospital, Paris, France; Denis Diderot University, Paris, France; DHU Protect INSERM U 1141, Robert Debré University Hospital, Paris, France.
    • Br J Anaesth. 2018 Aug 1; 121 (2): 462-468.

    BackgroundIntraoperative analgesia is still administered without guidance. Anaesthetists decide upon dosing on the basis of mean population opioid pharmacological studies and in response to variations in haemodynamic status. However, those techniques have been shown to be imprecise. We assessed the diagnostic value of monitoring the analgesia nociception index (ANI) to detect surgical stimulation in children.MethodsThis was an observational study of 2- to 12-yr-old patients 5 min before and after surgical incision. Hypnosis was maintained with sevoflurane and guided by bispectral index. Intraoperative analgesia was administered as a remifentanil infusion titrated to variations in haemodynamic parameters, and ANI monitor values were recorded. ANI parameters assessed included instantaneous ANI (ANIi), mean ANI (ANIm), and the relative change of ANIi to ANIm (DeltaANI=ANIi-ANIm/ANIm). Statistical analyses were performed using receiver-operating-characteristic analysis with determination of the area under the receiver operating characteristic (AUROC) curve and the grey zone.ResultsOverall, 49 subjects were included in this study. The AUROC was 0.755 (0.738-0.772), 0.771 (0.755-0.787), and 0.756 (0.738-0.774) for ANIi, ANIm, and DeltaANI, respectively. The threshold of ANI parameters indicating the presence of noxious surgical stimuli was ≤53%, ≤56%, and ≤-13.3% for ANIi, ANIm, and DeltaANI, respectively. The percentage of subjects in the inconclusive zone was 41%, 51%, and 33% for ANIi, ANIm, and DeltaANI, respectively.ConclusionsANI has diagnostic value for detecting surgical stimuli in children.Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…