title: Analgesia Nociception Index (ANI) to predict intraoperative haemodynamic changes: results of a pilot investigation.
abstract: BACKGROUND
  The Analgesia Nociception Index has been described to reflect different levels of intraoperative nociceptive stimulation during total intravenous anaesthesia. The association between this index and haemodynamic changes during sevoflurane-based anaesthesia was investigated in 30 patients with the hypothesis that changes in the Analgesia Nociception Index may coincide with or even predict haemodynamic changes.
  
  
  METHODS
  The Analgesia Nociception Index as well as blood pressure and heart rate were observed during induction, at skin incision, at times of an Analgesia Noceception Index decrease > 20% ('event') and pre-/post-fentanyl administration.
  
  
  RESULTS
  The Analgesia Nociception Index decreased with airway manipulation [mean: 52 (before) vs. 33 (after); P < 0.005] and after skin incision [mean: 63 (before) vs. 38 (after); P < 0.001], and it increased after fentanyl administration [53 (before) vs. 59 (after); P < 0.05]. However, its predictive probability to indicate heart rate and blood pressure increases of >10% was low (heart rate 0.61; blood pressure 0.59).
  
  
  CONCLUSIONS
  The Analgesia Nociception Index appears to reflect different levels of stimulation during sevoflurane-based general anaesthesia. However, it was of little predictive value to pre-empt significant haemodynamic changes.
authors.affiliation: Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, WA, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Ledowski
authors.forename: L
authors.initials: L
authors.lastname: Averhoff
authors.forename: W S
authors.initials: WS
authors.lastname: Tiong
authors.forename: C
authors.initials: C
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D059225:Nociception / Q000502:physiology*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D000077149:Sevoflurane; D013514:Surgical Procedures, Operative
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane