Cardiothoracic & vascular anesthesia
Utility of the nociception level index to monitor intraoperative nociception and predict acute postoperative pain in thoracic surgery
Authors' conclusion
NOL captures intraoperative stress with an accuracy allowing to differentiate large nociception changes at both the population and individual level after skin incision and nerve block. However, NOL was unable to differentiate between patients with plausibly different nociception levels, like patients undergoing different surgical or analgesic techniques.
Study context
- Population
- Thoracic surgery patients
- Participants
- 114 patients
- Exposure
- Nociception Level (NOL) responses to incision and nerve block; thoracotomy vs minimally invasive surgery; peridural anaesthesia vs intercostal nerve block
- Thoracotomyn = 37
- Minimally invasive surgeryn = 77reference
- Peridural anaesthesian = 40
- Intercostal nerve blockn = 74reference
- Outcome
- NOL's utility for measuring intraoperative nociception and predicting acute postoperative pain and opioid consumption
Main finding
As reported in the abstract
NOL response to incision and nerve block
- Population NOL significantly increased after incision
- p < 0.01
- Population NOL significantly decreased after nerve block
- p < 0.01
- Individual detection of nociception after incision
- AUC 0.68 (95%CI 0.61-0.75)
- Individual detection of nociception after nerve block
- AUC 0.62 (95%CI 0.53-0.72)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| NOL by surgical techniqueThoracotomy vs Minimally invasive surgery · NOL did not differ significantly | P = 0.12 |
| NOL by analgesic techniquePeridural anaesthesia vs Intercostal nerve block · NOL did not differ significantly | P = 0.16 |
Postoperative pain and opioid consumption by surgical and analgesic technique
- Significantly different postoperative pain and opioid consumption
- P < 0.01
NOL as predictor of postoperative pain or opioid consumption (multivariable)
- No significant effect of NOL on postoperative pain or opioid consumption
Original publication
Utility of the nociception level index to monitor intraoperative nociception and predict acute postoperative pain in thoracic surgery. J Clin Monit Comput. Published 2 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →