ANALGESIA NOCICEPTION INDEX: FROM OBJECTIVE EVALUATION OF NOCICEPTION TO ANALGESIA IMPROVEMENT
Keywords:
nociception, monitoring of pain, Analgesia Nociception IndexAbstract
The point when an aggressive surgical or diagnostic act is performed is that requires an adequate anesthesia performed by the anesthesiologist, where the analgesia is the leading component. The application of better part of subjective methods for the nociception assessment under general anesthesia or sedation is impossible and not applicant and the level of nociception during per- and post-surgery analgesia are evaluated clinically. Considerable pharmacological variability of analgesics doesn’t allow predicting individual sensitivity and individual needs for them. Here are considered clinical possibilities of a new method for assessment of the balance of nociception-antinonociception by usage of apparatus “ANI-Monitor” (MetroDoloris®, France), allowing to calculate the original index ANI (Analgesia Nociception Index). Based on the Heart Rate Variability, the objective and non-invasive method allows to monitor the level of pain perception during the per- and post-surgery periods and to adapt the analgesia protocol specifically for a given patient. ANI monitor can be used with patients of all age groups to assess the activity level of Autonomous Nervous System. During reanimation and intensive care periods ANI allows the activity determination of parasympathetic tone and the comfort level of the patient. Further studies are needed to determine the specificity and the threshold sensitivity of ANI index in various clinical conditions.
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