Saynhalath, Rita, Khan, Umar H., Alex, Gijo, Murphy, Joseph T., Szmuk, Peter Changes in the nociception level index during surgical resection of paragangliomas: A case report. A&A Practice 2021: 15 (11)- Outcomes Research Consortium

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Saynhalath, Rita, Khan, Umar H., Alex, Gijo, Murphy, Joseph T., Szmuk, Peter Changes in the nociception level index during surgical resection of paragangliomas: A case report. A&A Practice 2021: 15 (11)

October 16, 2021

Nociception is the detection of noxious stimulation by the nervous system. The PMD-200 monitor is a validated, emerging technology for intraoperative monitoring using the nociception level (NOL) index. We describe a pediatric case of an open resection of paraganglionic masses during which episodic increases in NOL index and blood pressure coincided with tumor manipulation, presumably due to a catecholamine surge. Since the patient was under stable and adequate analgesia, the increases in NOL index likely reflected the physiologic effects of tumor handling rather that the presence of a true noxious stimulus. Clinicians should consider this limitation when using this monitor. (A&A Practice. 2021;15:e01542.)