Abstract
The Analgesia Nociception Index is a dimensionless scale derived from the heart rate variability; by analyzing the heart rate variability oscillations, it reflects the activity of the sympathetic and parasympathetic nervous systems and ultimately helps to evaluate the Nociception–Antinociception balance during anesthesia and surgery. Drugs like ephedrine affect the heart rate variability inducing artifacts in the ANI readings which should be taken into account in the clinical practice and in clinical research.
This is a preview of subscription content, log in via an institution to check access.
References
Susano MJ, Vide S, Ferreira DA, et al. Effects of varying remifentanil concentrations on Analgesia Nociception Index under propofol: an observational stufy. J Clin Monit Comput. 2021;35(1):199–205. https://doi.org/10.1007/s10877-020-00457-3.
Logier R, Jeanne M, De Jonckeere J, et al. PhysioDoloris: a monitoring device for analgesia/nociception balance evaluation using heart rate variability analysis. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:1194–7. https://doi.org/10.1109/IEMBS.2010.56259712010.5625971.
Heart Rate Variability. Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology the North American Society of Pacing Electrophysiology. Circulation. 1996;93:1043–65.
Elghozi JL, Girard A, Laude D. Effects of drugs on the autonomic control of short-term heart rate variability. Auton Neurosci. 2001;90(1–2):116–21. https://doi.org/10.1016/S1566-0702(01)00276-4.
Statler AK, Maani CV, Kohli A. Ephedrine. In: StatPearls. Treasure Island: StatPearls Publishing; 2020. p. 20.
ANI Monitor V2 Product Brochure. https://mdoloris.com/wp-content/uploads/MDQUAEN74.ANIV2-v.03-EN-Product-Brochure-Web-Version.pdf. Accessed 14 Jan 2012 on the M’Doloris
Barvais L, Engelman E, Eba JM, et al. Effect site concentrations of remifentanil and pupil response to noxious stimulation. Br J Anaesth. 2003;91(3):347–52. https://doi.org/10.1093/bja/aeg178.
Funcke S, Sauerlaender S, Pinnschmidt HO, ET AL. Validation of innovative techniques for monitoring nociception during general anesthesia: a clinical study using tetanic and intracutaneous electrical stimulation. Anesthesiology. 2017;127(2):272–83. https://doi.org/10.1097/ALN0000000000001670.
Boselli E, Logier R, Bouvet L, et al. Prediction of hemodynamic reactivity using dynamic variations of Analgesia/Nociception Index (∆ANI). J Clin Monit Comput. 2015;30(6):977–84. https://doi.org/10.1007/s10877-015-9802-8.
Meijer FS, Niesters M, van Velzen M, et al. Does nociception monitor–guided anesthesia affect opioid consumption? A systematic review of randomized controlled trials. J Clin Monit Comput. 2020;34:629–41. https://doi.org/10.1097/ALN.0000000000002634.
Funding
No funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interests with the content of this letter to the Editor. Francisco A Lobo had served as speaker and consultant for M’Doloris but his role has no conflict with the content of this letter.
Ethical approval
Not applicable.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Graça, R., Lobo, F.A. Analgesia Nociception Index (ANI) and ephedrine: a dangerous liasion. J Clin Monit Comput 35, 953–954 (2021). https://doi.org/10.1007/s10877-021-00682-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10877-021-00682-4