Email this article Evaluation of Analgesic Nociceptive Index in intraoperative and postoperative pain management in general anesthesia applied with two different methods
DOI: https://doi.org/10.20528/cjpm.2024.01.002
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Aim: Effectiveness of analgesic nociceptive index (ANI) monitoring in predicting both intraoperative and postoperative early pain in neurosurgery patients undergoing lumbar spinal surgery. The patients were administered general anesthesia using different anesthesia management techniques.
Method: The study included a total of 60 patients with American Society of Anesthesiologist (ASA) I-III. The patients were randomly divided into two groups of 30 each using the closed envelope method. Group T received total intravenous anesthesia (TIVA) with remifentanil-propofol, while Group D with desflurane-remifentanil. Non-invasive ANI monitoring was applied to patients undergoing lumbar spinal surgery, and ANI, heart rate, systolic/diastolic arterial pressure values were recorded before and after induction, skin incision, major muscle incision, laminectomy, right-left fasciectomy, screw fixation, after extubation and during the postoperative period. Post-operative heart rate, ANI value, mean arterial pressure values, and visual analog scale (VAS) values were measured.
Results: No statistically significant difference was found in terms of the demographic data of the patients. According to the groups, no statistically significant difference was found between the ANI and VAS measurements of the cases at the postoperative 5th minute (P=0.261), postop 10th minute (P=0.379), postop 15th minute (P=0.673), postop 30th minute (P=0.784) and postop 60 minute (p =0.750).
Conclusions: In our study on lumbar spine surgery, we could not detect any significant relationship between ANI monitoring and VAS values in the early postoperative period. There was no difference in ANI and VAS with either anaesthetic technique. In light of the results of our study, we believe that more studies are needed on the use of ANI monitoring in the early postoperative period.
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References
Artukoğlu F, Asenjo JF. Anesthesia in spinal surgery. In AF Özer, editors. Lumbar degenerative disc disease and dynamic stabilization. American Hospital Publications. 2010: 194-199.
Lovich-Sapola J, Smith CE, Brandt CP. Postoperative pain control. Surg Clin North Am. 2015; 95(2):301-18
Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006; 367(9522):1618−25.
Eisenberg E. Post-surgical neuralgia. Pain 2004; 111(1-2):3-7.
Köprülü AŞ, Toptaş M, Gül YG, Haspolat A, Yılmaz H, Özenç E. Prediction of hemodynamic reactivity during sevoflurane remifentanyl anesthesia for laparoscopic cholecystectomy using Analgesia Nociception Index. Med Bull Haseki 2016; 54:212-218.
Fassoulaki A, Melemeni A, Paraskeva A, Siafaka I, Sarantopoulos C. Postoperative pain and analgesic requirements after anesthesia with sevoflurane, desflurane or propofol. Anesth Analg. 2008; 107(5):1715-9.
Wong SSC, Chan WS, Irwin MG, Cheung CW. Total intravenous anesthesia (TIVA) with propofol for acute postoperative pain: A scoping review of randomized controlled trials. Asian J Anesthesiol. 2020; 58(3):79-93.
Logier R, Jeanne M, De Jonck heere J, et al. Physio Doloris: a monitoring device for analgesia/nociception balance evaluation using heart rate variability analysis. Conf Proc IEEE Eng MedBiol Soc 2010; 2010:1194-7
Dundar N, Kus A, Gurkan Y, Toker K, Solak M. Analgesia nociception index (ani) monitoring in patients with thoracic paravertebral block: A randomized controlled study. J. Clin. Monit. Comput. 2018; 32: 481–486.
Le Gall L, David A, Carles P, Leuillet S, Chastel B, Fleureau C, Dewitte A, Ouattara A. Benefits of intraoperative analgesia guided by the Analgesia Nociception Index (ANI) in bariatric surgery: An unmatched case-control study. Anaesth. Crit. CarePain Med. 2019; 38: 35–39.
Sabourdin N, Burey J, Tuffet S, Thomin A, Rousseau A, Al-Hawari M, Taconet C, Louvet N, Constant I. Analgesia Nociception Index-guided remifentanil versus standard care during propofol anesthesia: A randomized controlled trial. J Clin Med. 2022; 11(2):333.
Baroni DA, Abreu LG, Paiva SM, Costa LR. Comparison between Analgesia Nociception Index (ANI) and self-reported measures for diagnosing pain in conscious individuals: a systematic review and meta-analysis. Sci Rep. 2022; 12(1):2862.
Boselli E, Bouvet L, Bégou G. Prediction of immediate postoperative pain using the analgesia/nociception index: a prospective observational study. Br J Anaesth. 2014; 112:715–721.
Charier D, Vogler MC, Zantour D, et al. Assessing pain in the postoperative period: Analgesia Nociception Index (TM) versus pupillometry. Br. J. Anaesth. 2019; 123:322–327.
Jeanne M, Delecroix M, De Jonckheere J, Keribedj A, Logier R, Tavernier B. Variations of the analgesia nociception index during propofol anesthesia for total knee replacement. Clin. J. Pain. 2014; 30:1084–1088.
Linzer P, Filip M, Šámal F, Kremr J, Šálek T, Gajdoš M, Jarkovský J. Comparison of biochemical markers of muscle damage and inflammatory response between the open discectomy, microsurgical discectomy, and microsurgica ldiscectomy using tubular retractor. J NeurolSurg A CentEurNeurosurg. 2015; 76(5):384-91.
Turan G, Ar AY, Kuplay YY, Demiroluk O, Gazi M, Akgun N, Celikoglu E. Índice de analgesia/nocicepção para monitorização da analgesia perioperatória na cirurgia da coluna vertebral [Analgesia Nociception Index for perioperative analgesia monitoring in spinal surgery]. Rev Bras Anestesiol. 2017; 67(4):370-375.
Lin WL, Lee MS, Wong CS, Chan SM, Lai HC, Wu ZF, Lu CH. Effects of intraoperative propofol-based total intravenous anesthesia on postoperative pain in spine surgery: Comparison with desflurane anesthesia - a randomised trial. Medicine (Baltimore). 2019; 98(13):e15074.
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