Ayvardgi A. A.

THE ANALGESIA/NOCICEPTION INDEX (ANI) AND ITS CORRELATION WITH SEPTOPLASTY


About the author:

Ayvardgi A. A.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scentific article

Annotation:

The aim of the study was to investigate the correlation of ANI with hemodynamic parameters, the level of postoperative pain by VAS, the duration of anesthesia, surgical intervention, blood loss, surgeons’ feedbacks and to evaluate the prognostic ability of the analgesia/nociception index regarding anesthesia, surgical intervention and the severity of postoperative pain syndrome. Object and methods. In this study, 116 patients with the curvature of the nasal septum who underwent septoplasty under the intravenous anesthesia + mechanical ventilation with local anesthesia with a 2% lidocaine solution were studied. Spearman rank correlation analysis for of the analgesia/nociception index (ANI) with parameters of hemodynamics (systolic index, mean arterial pressure , HR), volume of intraoperative blood loss, duration of anesthesia, surgeon’s assessment of the operating field and pain level by VAS in the postoperative period was carried out. The results of the study revealed an inversely proportional high correlation between ANI and hemodynamic parameters, the volume of blood loss, the duration of anesthesia at all stages of observation, from the induction of anesthesia to the awakening of patients and directly proportional high correlation between ANI and the surgeon’s assessment of the operating field. On the 2nd day after surgery an inverse proportion of the medium degree is noted between the level of ANI during anesthesia and the severity of the pain syndrome according to VAS. Scope of application of the results. The use of ANI can be recommended for implementation into practice in case of surgical interventions in the curvature of the nasal septum for predicting the severity of the pain syndrome in the postoperative period, and possibly for predicting a favourable course of anesthesia and surgical intervention. Conclusions. The increase in the level of ANI to the values of 60-70 at all stages of observation from the moment of induction of anesthesia and to the awakening of patients significantly correlates with the decrease in mean arterial pressure, HR, systolic index to the lower limits of the norm, the volume of blood loss, the duration of anesthesia and the level of pain by VAS on the 2nd day after surgery, and – with the increase in the surgeon’s assessment of the operating field. The level of ANI during surgery can be used to predict the level of pain syndrome in the postoperative period. The increase in the level of ANI within the normal range may be a prognostic criterion for the favourable course of anesthesia and surgical intervention.

Tags:

septoplasty, analgesia/nociception index (ANI), analgesia, hemodynamics, correlation

Bibliography:

  1. Dzh. Edvard Morgan-ml., Megid S. Mihail, Majkl Dzh. Marri. Klinicheskaya anesteziologiya. Moskva: Izdatelstvo Binom; 2011. s. 399-400. [in Russian].
  2. Spasova AP, Tihova GP, Bazarov RO. Indeks analgezii-nocicepcii: vozmozhnosti i predely. Vestnik anesteziologii i reanimtaologii. 2015;12(5):6470. [in Russian].
  3. Kobelyackij YuYu, Shajda OO. Suchasni metodi ob’yektivizaciyi bolyu ta nocicepciyi. Medicina neotlozhnyh sostoyanij. 2015;2(65):19-23. [in Ukrainian].
  4. Goldovskij BM, Potalov SA, Sid EV, Serikov KV, Nasteka NV. Vliyanie stressa na pokazateli variabelnosti serdechnogo ritma u sotrudnikov vyezdnogo personala skoroj medicinskoj pomoshi. Medicina neotlozhnyh sostoyanij. 2015;8(71):92-5. [in Russian].
  5. Chumachenko ED. Analgesia Nociception Index: ot obektivnoj ocenki nocicepcii k optimizacii obezbolivaniya. Klinichna anesteziologiya ta intensivna terapiya. 2014;2(4):90-102. [in Russian].
  6. Dundar N, Kus A, Gurkan Y, Toker K, Solak M. Analgesia nociception index (ani) monitoring in patients with thoracic paravertebral block: a randomized controlled study. J Clin Monit Comput. 2018 Jun;32(3):481-6. DOI: 10.1007/s10877-017-0036-9
  7. Henry D. Upton, Guy L. Ludbrook, Andrew Wing, Jamie W. Sleigh. Intraoperative “Analgesia Nociception Index” – Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy. A Randomized Clinical Trial. Anesthesia & analgesia. 2017;125(1):1-10.
  8. Guldem Turan, Arzu Yildirim Ar, Yildiz Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, et al. Analgesia Nociception Index for perioperative analgesia monitoring in spinal surgery. Brazilian Journal of Anesthesiology. 2017;67(4):370-5.
  9. Zarzar AS, Kim EV, Ataxanov ShE, Maxmudov MA, Zabitova ZM. Ispolzovanie mikrokalkulyatorov dlya raschyota gemodinamicheskix parametrov levogo zheludochka. Anesteziologiya i reanimatologiya. 1991;2:2. [in Russiаn].

Publication of the article:

«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 71-75 pages, index UDK 616 – 089. 5 – 06: 616. 216

DOI: