Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Introduction: Pain is highly prevalent in critically ill trauma patients, especially those with a traumatic brain injury (TBI). Behavioral pain tools such as the behavioral pain scale (BPS) and critical-care pain observation tool are recommended for sedated noncommunicative patients. Analysis of heart rate variability (HRV) is a noninvasive method to evaluate autonomic nervous system activity. The analgesia nociception index (ANI) device (Physiodoloris, MDoloris Medical Systems, Loos, France) allows noninvasive HRV analysis. The ANI assesses the relative parasympathetic tone as a surrogate for antinociception/nociception balance in sedated patients. The primary aim of our study was to evaluate the effectiveness of ANI in detecting pain in TBI patients. The secondary aim was to evaluate the impact of norepinephrine use on ANI effectiveness and to determine the correlation between ANI and BPS.
Methods: We performed a prospective observational study in 21 deeply sedated TBI patients. Exclusion criteria were nonsinus cardiac rhythm; presence of pacemaker; atropine or isoprenaline treatment; neuromuscular blocking agents; and major cognitive impairment. Heart rate, blood pressure, and ANI were continuously recorded using the Physiodoloris device at rest (T1), during (T2), and after the end (T3) of the painful stimulus (tracheal suctioning).
Results: In total, 100 observations were scored. ANI was significantly lower at T2 (Median [min - max] 54.5 [22-100]) compared with T1 (90.5 [50-100], < 0.0001) and T3 (82 [36-100], < 0.0001). Similar results were found in the subgroups of patients with (65 measurements) or without (35) norepinephrine. During procedure, a negative linear relationship was observed between ANI and BPS (r = -0.469, < 0.001). At the threshold of 50, the sensitivity and specificity of ANI to detect patients with BPS ≥ 5 were 73% and 62%, respectively, with a negative predictive value of 86%.
Discussion: Our results suggest that ANI is effective in detecting pain in ventilated sedated TBI patients, including those patients treated with norepinephrine.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613610 | PMC |
| http://dx.doi.org/10.4103/ijccm.IJCCM_419_16 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Practice Pattern Variability in the Use of Pulmonary Arterial Catheters in Cardiac Surgery.
J Cardiothorac Vasc Anesth
August 2025
Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Objectives: To quantify intraoperative pulmonary arterial catheter (PAC) use during cardiac surgery and identify hospital-, anesthesiologist-, and patient-level factors associated with PAC utilization.
Design: A cross-sectional, observational study using generalized logistic mixed models to examine variations in PAC use.
Setting: Fifty-three US academic hospitals participating in the Multicenter Perioperative Outcomes Group (MPOG) national registry PARTICIPANTS: 145,343 adult patients undergoing cardiac surgery between January 1, 2016, and December 31, 2022.
Influence of psychological factors on the benefit from interpectoral and pectoserratus plane block for recovery after partial mastectomy: a randomized controlled trial.
Korean J Anesthesiol
February 2025
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Background: The interpectoral and pectoserratus plane (PECs) blocks have been reported to provide favorable postoperative analgesia after mastectomy. However, studies have reported controversial data regarding its effect on the quality of recovery (QoR). We aimed to evaluate the effect of the PECs block in light of baseline psychological factors and pain sensitivity.
View Article and Find Full Text PDF1, 2, 4-trimethoxybenzene alleviates pain and related psychiatric disorders by inhibiting NLRP3 inflammasome activation.
Neurosci Lett
September 2025
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China. Electronic address:
Pain and pain-related psychiatric diseases affect approximately one-third of the global population, and effective treatment remains a lack of options. NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome is regarded as a potential therapeutic target for managing pain and related psychiatric diseases. Our previous research reported that 1,2,4-trimethoxybenzene (1,2,4-TTB) effectively inhibited NLRP3 inflammasome activity.
View Article and Find Full Text PDFCan't Hold any More! A Large Survey on Cycling Subjective Experience at the Limit of Effort.
Psychol Sport Exerc
September 2025
Department of Experimental Psychology, University of Granada, Granada, Spain; Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.
Cyclists frequently experience task failure, an abrupt inability to maintain high-intensity effort, pushing both physiological and psychological boundaries. Although the physiological underpinnings of task failure are well-documented, the associated subjective and perceptual experiences remain underexplored. To address this gap, we surveyed 2,818 licensed cyclists, gathering extensive data on the subjective aspects of reaching the point of exhaustion.
View Article and Find Full Text PDFInfluence of amitriptyline therapy on T cell phenotype in chronic pain patients.
Biomed Pharmacother
September 2025
Institute of Medical Microbiology, University Hospital Essen, University Duisburg-Essen, Germany.
Chronic pain (CP) is a major health issue globally, affecting millions and resulting in a significant healthcare burden. Although amitriptyline is widely used to manage CP, its immunomodulatory effects during pain therapy, especially on T cell phenotypes, remain unclear. In this study, we explored how amitriptyline alters T cell phenotypes in CP patients.
View Article and Find Full Text PDF