The Analgesia Nociception Index (ANI) monitor’s “Energy” variable detects autonomic state modification during general anesthesia, sedation and spinal anesthesia: a retrospective cohort study
Authors' conclusion
"Energy" decreases after the induction of general anesthesia and sedation and thus reflects a lower degree of autonomic modulation.
Study context
- Population
- Procedures under GA, spinal anesthesia or sedation, Lille University Medical Center, 2012–2024; arrhythmia or missing baseline data excluded
- Participants
- 2,226 procedures
- Exposure
- Change in ANI "Energy" across pre-induction (P1), post-induction (P2) and intraoperative (P3) periods in GA, sedation and spinal anesthesia
- Outcome
- Variations in ANI "Energy" (overall heart rate variability modulation)
- Follow-up
- P1 (pre-induction) to P2 (post-induction) and P3 (intraoperative)
Methodological detailssingle-centre data warehouse, linear mixed models adjusted for age, ASA score, norepinephrine use and sex
- Single-centre data warehouse
- Linear mixed models adjusted for age, ASA score, norepinephrine use and sex
Main finding
As reported in the abstract
Adjusted change in "Energy"
- General anesthesia · P1-P2
- Mean (SD) −0.306 (CI −0.321 to −0.292); P < 0.001
- General anesthesia · P1-P3
- Mean (SD) −0.334 (CI −0.348 to −0.319); P < 0.001
- Sedation · P1-P2
- −0.120 (CI −0.176 to −0.064); P < 0.001
- Sedation · P1-P3
- −0.113 (CI −0.168 to −0.056); P < 0.001
- Spinal anesthesia · P1-P2
- 0.082 (CI 0.017–0.146); P = 0.012
- Spinal anesthesia · P1-P3
- 0.089 (CI 0.025–0.153); P = 0.006
Observational data: associations, not effects.
Original publication
The ANI monitor’s “Energy” variable detects autonomic state modification during general anesthesia, sedation and spinal anesthesia: a retrospective cohort study. J Clin Monit Comput. Published 29 November 2025. doi:10.
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