March 17, 2023
Background:
Nociception-guided intraoperative opioid administration might help reduce postoperative pain. A commonly used and validated nociception monitor sys- tem is nociception level (NOL), which provides the nociception index, ranging from 0 to 100, with 0 representing no nociception and 100 representing extreme nocicep- tion. We tested the hypothesis that NOL responses are similar in men and women given remifentanil and fentanyl, across various types of anesthesia, as a function of American Society of Anesthesiologists physical status designations, and over a range of ages and body morphologies.
Methods: We conducted a retrospective cohort analysis of trial data from eight pro- spective NOL validation studies. Among 522 noncardiac surgical patients enrolled in these studies, 447 were included in our analysis. We assessed NOL responses to vari- ous noxious and non-noxious stimuli.
Results: The average NOL in response to 315 noxious stimuli was 47 ± 15 (95% CI = 45–49). The average NOL in response to 361 non-noxious stimuli was 10 ± 12 (95% CI = 9–11). NOL responses were similar in men and women, in patients given remifentanil and fentanyl, across various types of anesthesia, as a function of Ameri- can Society of Anesthesiologists physical status designations, and over a range of ages and body morphologies.
Conclusion: Nociception level appears to provide accurate estimates of intraoperative nociception over a broad range of patients and anesthetic conditions.
K E Y W O R D S
analgesia, fentanyl, monitoring, nociception, pain, PMD-200
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