Can postoperative pain be predicted? New parameter: analgesia nociception index

Authors: ALİ ŞEFİK KÖPRÜLÜ, ALİ HASPOLAT, YAŞAR GÖKHAN GÜL, NURŞEN TANRIKULU

Abstract: Background/aim: The Analgesia Nociception Index (ANI) is a new method of identifying nociception-analgesia balance. In this study, we investigate the correlation between the ANI and numeric rating scale (NRS) values immediately before and after extubation. The NRS values were recorded in the postanesthesia care unit, in a group of patients who underwent laparoscopic cholecystectomy, with the aim of evaluating the potential use of ANI values in the prediction of postoperative pain levels.Materials and methods: The ANI and NRS values, heartbeat rate (HR), systolic and diastolic arterial pressure (SAP/DAP), and oxygen saturation (SpO2) values of the patients were recorded into three groups based on the initial NRS values recorded in the postanesthesia care unit (group I: NRS ≤ 3, group II: NRS 4-6, group III: NRS ≥ 7). Patients whose ANI values were lower than 47, considered as the pain threshold, and the groups to which these patients belonged were also recorded.Results: Statistically significant increases were noted in HR, SAP, and DAP after extubation, while there was no significant change in ANI values. A weak correlation was identified between the ANI and NRS values of all patient groups.Conclusion: We failed to identify a correlation between ANI and NRS values before and after extubation. Previous studies suggested that the ANI provides more valuable information in anesthetized patients, whereas our findings show that it is ineffective in the prediction of potential postoperative pain.

Keywords: General anesthesia, postoperative pain, intra/postoperative monitoring, analgesia nociception index

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