The Relationship between Pre-Anesthetic Analgesia and Nociception (ANI) and Propofol Injection Pain among Patients Receiving Remifentanil: A Prospective, Randomized, Controlled Study
<i>Background and Objectives</i>: The analgesia/nociception index (ANI) potentially monitors nociceptive status during anesthesia, but its link to preoperative pain sensitivity is unclear. We investigated the relationship between pre-anesthetic ANI scores and propofol injection pain (PIP...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/60/2/273 |
| Summary: | <i>Background and Objectives</i>: The analgesia/nociception index (ANI) potentially monitors nociceptive status during anesthesia, but its link to preoperative pain sensitivity is unclear. We investigated the relationship between pre-anesthetic ANI scores and propofol injection pain (PIP) in patients receiving remifentanil. <i>Materials and Methods</i>: This study included 124 male patients aged 19–60 undergoing general anesthesia (ASA class I or II). Patients were randomized to group R (<i>n</i> = 62, remifentanil 4 ng/mL) or group C (<i>n</i> = 62, saline). The primary outcome was the association between PIP and ANI. Secondary outcomes included the incidence and severity of PIP or rocuronium-induced withdrawal movement (RIWM) and their association with ANI. <i>Results</i>: PIP and RIWM incidence and severity were lower in group R than in group C. A weak negative correlation between PIP and ANI at pre-induction <i>(r<sub>pb</sub></i> = −0.21, <i>p</i> = 0.02, <i>r<sub>pb</sub></i> = −0.37, <i>p</i> < 0.01) and a moderate negative correlation during propofol injection (<i>r<sub>pb</sub></i> = −0.48, <i>p</i> = 0.02) were observed. A significant negative correlation was found between RIWM and ANI during rocuronium injection (τb = −0.61, <i>p</i> < 0.01). AUC, cut-off value, specificity, and sensitivity in ANI at pre-induction for predicting PIP were 0.67 (<i>p</i> = 0.02), 59, 76%, and 55%, respectively. AUC, cut-off value, specificity, and sensitivity in ANI during propofol injection for PIP were 0.77 (<i>p</i> < 0.01), 65, 81%, and 67%, respectively. <i>Conclusions</i>: ANI scores demonstrated significant differences between groups, suggesting potential predictive value for PIP despite the low pre-induction AUC value. This study highlights the potential of using ANI scores to predict and manage PIP in patients receiving remifentanil. |
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| ISSN: | 1010-660X 1648-9144 |