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Nociception Monitoring for General Anesthesia: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Published on: December 12, 2018
Project Number: RC1050-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of nociception monitoring on pain, opioid/pain medication consumption and/or opioid-related adverse events in adult surgical patients who have undergone general anesthesia?
  2. What is the cost-effectiveness of nociception monitoring on pain, opioid/pain medication consumption and/or opioid-related adverse events in adult surgical patients who have undergone general anesthesia?
  3. What are evidence-based guidelines informing the use of nociception monitoring on pain, opioid/pain medication consumption and/or opioid-related adverse events in adult surgical patients who have undergone general anesthesia?

Key Message

There is a suggestion that in adult patients undergoing surgery under general anesthesia, the intraoperative opioid consumption is generally less with nociception monitoring compared with standard monitoring, however the between group differences were not always statistically significant. There appears to be no statistically significant difference between nociceptive monitoring and standard monitoring with respect to intraoperative adverse events, postoperative opioid or analgesic consumption, postoperative pain, and postoperative adverse events.Findings need to be interpreted in the light of limitations (such as a limited number of studies on each surgery type and anesthetic protocol, lack of detail regarding standard monitoring procedures, and not all relevant outcomes reported in all the studies).No relevant evidence regarding the cost-effectiveness of and no evidence-based guidelines regarding nociceptive monitoring in adult patients undergoing surgery under general anesthesia were identified.

Tags

anesthesia, pain management, anesthesia, general, anesthetics, general, nociception, nociceptive pain, pain measurement, pain, postoperative, surgery, NOL, ANI, Pain, nocioception, Nociperception, nociceptor, pain rating, Scale, Scales, pain index, pain indices, perioperative, intra-operative, intraoperative, post-operative pain, Anaesthesia, Anaesthetic