Anaesthetic drugs & techniques
Pre-induction nociception indices are associated with post-induction hypotension during general anesthesia in older patients: a prospective observational study
Authors' conclusion
Pre-induction HFVI/ANI and NOL were associated with the occurrence and cumulative burden of post-induction hypotension in patients aged ≥ 65 years, suggesting their potential utility as pre-induction screening tools.
Study context
- Population
- Patients aged ≥ 65 years undergoing elective surgery under GA (induction: remifentanil 0.2 µg/kg/min for 2 min, then propofol 2 mg/kg bolus)19 men
- Participants
- 51 patients
- Exposure
- Hypotension vs Nonhypotension
- Hypotensionn = 22
- Nonhypotensionn = 29reference
- Outcome
- Prediction of post-induction hypotension (MAP < 65 mmHg) by pre-induction HFVI/ANI and NOL values (ROC analysis)
- Follow-up
- 5 min after induction
Main finding
As reported in the abstract
Pre-induction nociception indices and post-induction hypotension
| Group | Value | Nociception Level (NOL) |
|---|---|---|
| Hypotension | 58.7 ± 11.1 | 17.2 ± 9.1 |
| Nonhypotension | 69.0 ± 15.1 | 10.7 ± 8.8 |
Value
Hypotension58.7 ± 11.1
Nonhypotension69.0 ± 15.1
Nociception Level (NOL)
Hypotension17.2 ± 9.1
Nonhypotension10.7 ± 8.8
- Hypotension vs Nonhypotension: P = 0.010 — lower High Frequency Variability Index (HFVI)/ANIi in hypotension group
- Hypotension vs Nonhypotension: P = 0.013 — higher NOL in hypotension group
- HFVI/ANIi AUC for predicting hypotension (cutoff = 62.5)
- 0.72
- NOL AUC for predicting hypotension (cutoff = 13.5)
- 0.71
Observational data: associations, not effects.
Further findings
Correlation of AUT-65 (area under mean arterial pressure (MAP) < 65 mmHg) with nociception indices
- HFVI/ANIi, Spearman rho (p = 0.013)
- - 0.35
- NOL, rho (p = 0.0005)
- 0.47
Original publication
Pre-induction nociception indices are associated with post-induction hypotension during general anesthesia in older patients: a prospective observational study. J Clin Monit Comput. Published 14 July 2026. doi:10.
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