Effectiveness of analgesia nociception index on pain assessment in laparoscopic surgery under total intravenous anesthesia / 实用医学杂志

ABSTRACT

Objective To observe the correlation between analgesia nociception index (ANI) and hemodynamic changes during laparoscopic surgery after tracheal intubation andto assess the effectiveness of ANI.Methods A multicenter, prospective clinical study was conducted and 284 patients underwent laparoscopic surgery were enrolled. Patients were monitored after entering the operating room. Endotracheal intubation was completed by anesthesia induction with target controlled remifentanil and propofol, after arterial and central venous catheterization were improved. Anesthesia was maintainedby continued propofol and remifentanil target controlled infusion.The ANI value, systolic pressure, heart rate of 5 minutes after completion of the entry, completion of the first trocar and completion of all the trocars were recorded. The ANI values and the changes in the vital signs (systolicblood pressure and heart rate) were observed during the laparoscopic operation, and the effectiveness of the ANI index to assess the pain caused by the insertion of a laparoscope trocar was evaluated. Results (1) The area under the ANI curve was positively correlated with the one under thesystolic blood pressure and the heart rate curve during the period from cutting the skin to 5 mins after completing all the trocars (P < 0.05). (2) ANI was negatively correlated with SBP and HR when skin incision and the first trocar were completed (P < 0.001). Conclusions The changes in ANI were in accordance with the balance between analgesic and noxious stimuli, and negatively correlated with the changes insystolic blood pressure and heart rate. ANI could accurately evaluate the pain situation when the card was inserted.