The effectiveness of analgesia nociception index monitoring in patients who undergo colonoscopy with sedoanalgesia [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-45077

The effectiveness of analgesia nociception index monitoring in patients who undergo colonoscopy with sedoanalgesia

Merve Soral1, Gülbin Töre Altun2, Pelin Corman Dincer3, Mustafa Kemal Arslantaş3, Zuhal Aykac3
1Kastamonu State Hospital, Kastamonu, Turkey
2Marmara University Pendik Training and Research Hospital, Anaesthesiology and Reanimation Department, Istanbul, Turkey
3Marmara University, School of Medicine, Anaesthesiology and Reanimation Department, Istanbul, Turkey

Objective: It is targeted to improve patient comfort and safety during procedures done under anesthesia and sedation. The analgesia nociception index (ANI), non-invasively provide information on the nociception-antinociception balance, can be used to assess analgesia objectively. It is aimed to compare the effects of analgesia management by conventional methods and by ANI monitoring on total opioid consumption, sedation and analgesia levels who undergo colonoscopy with use of sedoanalgesia.
Methods: Adult patients (n: 102), scheduled for procedural sedation are prospectively analyzed. After induction with propofol and ketamine; infusions of propofol (2mg kg-1 h-1) and remifentanil (0.05 mcg kg-1 min-1) were started. In group A remifentanil infusions were titrated to maintain ANI value between 50-70, in group C analgesic requirements were met according to attending anaesthetist’s intention. Heart rate, blood pressure, respiratory rate, SpO2, BIS, NRS, Ramsay Sedation Scale were monitored. Complications, analgesics consumption, duration of the procedure, demographic information, NRS and Modified Aldrete Score were evaluated.
Results: Total remifentanil amount used in group A was 66,51±47,87mcg and 90,15±58,17mcg in group C (p: 0.011); there was no difference in total amounts of ketamine and propofol given. There was a negative correlation between ANI and NRS scores of group A patients at minute 0 at the level of 0.402, which was significant statistically (p=0.003).
Conclusion: Opioid consumption was diminished when ANI monitoring was used, thus patient safety was ameliorated. Further studies with longer procedure times and with greater number of patients are needed to demonstrate if a difference exists in side effects and recovery times.

Keywords: analgesia nociception index, sedoanalgesia, sedation, colonoscopy

Corresponding Author: Pelin Corman Dincer, Türkiye

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