Qnox index for quantification of intraoperative nociception and analgesia: a prospective single-centre validation study
Authors' conclusion
Qnox had a poor ability to discriminate noxious stimuli from non-noxious stimuli.
Study context
- Population
- Adults scheduled for elective surgery under propofol anaesthesia with neuromuscular block
- Participants
- 83 adults
- Comparison
- Qnox index vs HR and MAP for discriminating noxious from non-noxious stimuli
- Outcome
- Ability to discriminate noxious stimuli (tetanic 1, tetanic 2, skin incision, tracheal intubation) from a non-noxious period (AUC)
Methodological detailssingle-centre
- Single-centre
Performance
As reported in the abstract
Discrimination of noxious from non-noxious stimuli (AUC)
| Test or model | AUC tetanic 2 | AUC tetanic 1 | AUC skin incision | AUC tracheal intubation |
|---|---|---|---|---|
| Qnox | 0.52 (95% CI 0.43-0.61) | 0.54 (0.45-0.62) | 0.67 (0.58-0.75) | 0.65 (0.57-0.73) |
Qnox
AUC tetanic 20.52 (95% CI 0.43-0.61)
AUC tetanic 10.54 (0.45-0.62)
AUC skin incision0.67 (0.58-0.75)
AUC tracheal intubation0.65 (0.57-0.73)
Further findings
Qnox response to stimuli (post-stimulus values)
- Qnox increased significantly after tracheal intubation and skin incision, but not after tetanic 1 or tetanic 2
Qnox after skin incision at two target remifentanil concentrations
- Qnox values similar between low- and high-remifentanil-concentration groups
Original publication
Qnox index for quantification of intraoperative nociception and analgesia: a prospective single-centre validation study. Br J Anaesth. Published 23 January 2025. doi:10.
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