{"title":"Effect of postoperative peripheral nerve blocks on the analgesia nociception index under propofol anesthesia: an observational study.","authors":"Motoi Kumagai, Naoto Yamada, Masahiro Wakimoto, Shohei Ogawa, Sho Watanabe, Kotaro Sato, Kenji S Suzuki","doi":"10.1007/s10877-025-01264-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>The increased ANI value after PNB under propofol anesthesia may be a valuable indicator for assessing PNB efficacy.</p><p><strong>Trial registration number: </strong>UMIN000050334.</p><p><strong>Date of registration: </strong>February 28, 2023.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Monitoring and Computing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10877-025-01264-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
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.
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.
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