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

IF 2 3区医学 Q2 ANESTHESIOLOGY

Journal of Clinical Monitoring and Computing Pub Date : 2025-01-29 DOI:10.1007/s10877-025-01264-4

Motoi Kumagai, Naoto Yamada, Masahiro Wakimoto, Shohei Ogawa, Sho Watanabe, Kotaro Sato, Kenji S Suzuki

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引用次数: 0

Abstract

Purpose: The analgesia nociception index (ANI), also referred to as the high frequency variability index (HFVI), is reported to be an objective measure of nociception. This study investigated changes in ANI after peripheral nerve blocks (PNB) under general anesthesia. Understanding these changes could enhance assessment of PNB efficacy before emergence from general anesthesia.

Methods: This study enrolled 30 patients undergoing elective upper limb surgery. After surgery, median and maximum ANI values were recorded during two periods: a 5-minute period before PNB and a 20-minute period after PNB. The numeric rating scale (NRS) for pain was assessed twice: immediately after emergence from general anesthesia (N1) and the maximum pain experienced by the following morning after PNB effects subsided (N2). The difference in ANI before and after PNB was tested using the Wilcoxon signed-rank test. Statistical significance was set at P < 0.05.

Results: The ANI significantly increased after PNB in both the median (pre vs. post PNB value: 53.5 [44.0-68.0] vs. 59.0 [47.0-78.3], median [interquartile range]; P < 0.05) and maximum values (64.0 [56.3-79.5] vs. 74.5 [61.5-85.3]; P < 0.01). Secondary analysis revealed that significant ANI increases in both median (48.0 [42.3-66.5] vs. 61.0 [50.0-76.5]; P < 0.01) and maximum values (58.5 [50.3-75.3] vs. 76.0 [71.8-83.5]; P < 0.01) in the 18 cases with N2 ≥ 4 whereas no statistical differences were observed in the 12 cases with N2 < 4.

Conclusion: The increased ANI value after PNB under propofol anesthesia may be a valuable indicator for assessing PNB efficacy.

Trial registration number: UMIN000050334.

Date of registration: February 28, 2023.

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术后周围神经阻滞对异丙酚麻醉下镇痛伤害感觉指数的影响：一项观察性研究。

目的：镇痛伤害感受指数（ANI），也称为高频变异性指数（HFVI），是一种客观的伤害感受测量方法。本研究探讨了全身麻醉下周围神经阻滞（PNB）后ANI的变化。了解这些变化有助于在全麻苏醒前评估PNB的疗效。方法：本研究纳入30例择期上肢手术患者。手术后，在PNB前5分钟和PNB后20分钟两个时间段记录ANI中值和最大值。疼痛的数值评定量表（NRS）评估两次：全麻苏醒后立即（N1）和PNB效应消退后第二天早上经历的最大疼痛（N2）。采用Wilcoxon符号秩检验检验PNB前后ANI的差异。结果：PNB后ANI的中位数(PNB前后值：53.5[44.0-68.0]对59.0[47.0-78.3]，中位数[四分位数范围]均显著升高；结论：异丙酚麻醉下PNB术后ANI值升高可作为评价PNB疗效的重要指标。试验注册号：UMIN000050334。注册日期：2023年2月28日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Monitoring and Computing ANESTHESIOLOGY-

CiteScore

4.30

自引率

13.60%

发文量

144

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine. The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group. The journal publishes original papers, narrative and systematic reviews, technological notes, letters to the editor, editorial or commentary papers, and policy statements or guidelines from national or international societies. The journal encourages debate on published papers and technology, including letters commenting on previous publications or technological concerns. The journal occasionally publishes special issues with technological or clinical themes, or reports and abstracts from scientificmeetings. Special issues proposals should be sent to the Editor-in-Chief. Specific details of types of papers, and the clinical and technological content of papers considered within scope can be found in instructions for authors.