Validation of three nociception indices to predict immediate postoperative pain before emergence from general anaesthesia: a prospective double-blind, observational study
Authors' conclusion
Heart rate, Surgical Pleth Index, Pupillary Pain Index, and Nociception Level measured before emergence from general anaesthesia do not yet have sufficient diagnostic accuracy for prediction of postoperative pain.
Study context
- Population
- Patients undergoing trauma or orthopaedic surgery under GA; indices recorded for 5 min after end of surgery before return of consciousnessanalysed
- Participants
- 60 patients
- Comparison
- HR vs Surgical Pleth Index (SPI) vs Pupillary Pain Index (PPI) vs Nociception Level (NOL) for prediction of postoperative pain
- Outcome
- Predictive accuracy (AUC) for moderate-to-severe postoperative pain
- Follow-up
- 2 h in recovery room
Methodological detailsprospective, double-blind, observational
- Prospective
- Double-blind
- Observational
Performance
As reported in the abstract
Moderate-to-severe postoperative pain
| Test or model | AUC |
|---|---|
| HR | 0.46 [0.29-0.64], P=0.671 |
| SPI | 0.46 [0.31-0.61], P=0.621 |
| PPI | 0.52 [0.36-0.68], P=0.770 |
| NOL | 0.66 [0.51-0.81], P=0.038 |
AUC
HR0.46 [0.29-0.64], P=0.671
SPI0.46 [0.31-0.61], P=0.621
PPI0.52 [0.36-0.68], P=0.770
NOL0.66 [0.51-0.81], P=0.038
Further findings
Multivariable predictor (NOL + ASA physical status + use of RA)
- AUC (95% CI), multivariable logistic regression
- 0.83 [0.72-0.94], P<0.001
Original publication
Validation of three nociception indices to predict immediate postoperative pain before emergence from general anaesthesia: a prospective double-blind, observational study. Br J Anaesth. Published 4 January 2023. doi:10.
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