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Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI).
Br J Anaesth 2013; 111(3):453-9BJ

Abstract

BACKGROUND

The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general anaesthesia.

METHODS

Two-hundred patients undergoing scheduled surgery or endoscopy with general anaesthesia were included in this prospective observational study. Pain intensity was assessed using a 0-10 numerical rating scale (NRS) after arousal from general anaesthesia. Receiver-operating characteristic (ROC) curves were built to assess the performance of ANI to detect patients with NRS>3 and NRS ≥ 7 on arrival in the postoperative care unit.

RESULTS

A negative linear relationship was observed between ANI and NRS (ANI=-5.2 × NRS+77.9, r(2)=0.41, P<0.05). At the threshold of 57, the sensitivity and specificity of ANI to detect patients with NRS>3 were 78 and 80%, respectively, with a negative predictive value of 88%, corresponding to an area under the ROC curve (AUC) of 0.86. At the threshold of 48, the sensitivity and specificity of ANI to detect NRS ≥ 7 were 92 and 82%, respectively, with a negative predictive value of 99%, corresponding to a ROC curve AUC of 0.91.

CONCLUSIONS

A measurement of ANI during the immediate postoperative period is significantly correlated with pain intensity. The measurement of ANI appears to be a simple and non-invasive method to assess immediate postoperative analgesia.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care, Édouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France. emmanuel.boselli@chu-lyon.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23592690

Citation

Boselli, E, et al. "Prospective Observational Study of the Non-invasive Assessment of Immediate Postoperative Pain Using the Analgesia/nociception Index (ANI)." British Journal of Anaesthesia, vol. 111, no. 3, 2013, pp. 453-9.
Boselli E, Daniela-Ionescu M, Bégou G, et al. Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI). Br J Anaesth. 2013;111(3):453-9.
Boselli, E., Daniela-Ionescu, M., Bégou, G., Bouvet, L., Dabouz, R., Magnin, C., & Allaouchiche, B. (2013). Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI). British Journal of Anaesthesia, 111(3), pp. 453-9. doi:10.1093/bja/aet110.
Boselli E, et al. Prospective Observational Study of the Non-invasive Assessment of Immediate Postoperative Pain Using the Analgesia/nociception Index (ANI). Br J Anaesth. 2013;111(3):453-9. PubMed PMID: 23592690.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI). AU - Boselli,E, AU - Daniela-Ionescu,M, AU - Bégou,G, AU - Bouvet,L, AU - Dabouz,R, AU - Magnin,C, AU - Allaouchiche,B, Y1 - 2013/04/16/ PY - 2013/4/18/entrez PY - 2013/4/18/pubmed PY - 2013/10/30/medline KW - analgesia/nociception index KW - assessment KW - pain KW - postoperative SP - 453 EP - 9 JF - British journal of anaesthesia JO - Br J Anaesth VL - 111 IS - 3 N2 - BACKGROUND: The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general anaesthesia. METHODS: Two-hundred patients undergoing scheduled surgery or endoscopy with general anaesthesia were included in this prospective observational study. Pain intensity was assessed using a 0-10 numerical rating scale (NRS) after arousal from general anaesthesia. Receiver-operating characteristic (ROC) curves were built to assess the performance of ANI to detect patients with NRS>3 and NRS ≥ 7 on arrival in the postoperative care unit. RESULTS: A negative linear relationship was observed between ANI and NRS (ANI=-5.2 × NRS+77.9, r(2)=0.41, P<0.05). At the threshold of 57, the sensitivity and specificity of ANI to detect patients with NRS>3 were 78 and 80%, respectively, with a negative predictive value of 88%, corresponding to an area under the ROC curve (AUC) of 0.86. At the threshold of 48, the sensitivity and specificity of ANI to detect NRS ≥ 7 were 92 and 82%, respectively, with a negative predictive value of 99%, corresponding to a ROC curve AUC of 0.91. CONCLUSIONS: A measurement of ANI during the immediate postoperative period is significantly correlated with pain intensity. The measurement of ANI appears to be a simple and non-invasive method to assess immediate postoperative analgesia. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/23592690/Prospective_observational_study_of_the_non_invasive_assessment_of_immediate_postoperative_pain_using_the_analgesia/nociception_index__ANI__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)32403-0 DB - PRIME DP - Unbound Medicine ER -