The Newborn Infant Parasympathetic Evaluation (NIPE™) monitor predicts post-operative pain in children undergoing day-procedures: A prospective observational study.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 26 11 2022
accepted: 12 12 2022
pubmed: 17 1 2023
medline: 21 3 2023
entrez: 16 1 2023
Statut: ppublish

Résumé

Pain assessment is essential for the administration of appropriate analgesia. Currently, clinicians use surrogate methods, such as heart rate or behavioural pain scales, to estimate pain in neonates and infants. The Newborn and Infant Parasympathetic Evaluation (NIPE™) monitor aims to provide an objective numeric value (NIPE index) of pain through a continuous assessment of the patient's parasympathetic activity. The aim of this study was to determine if the intraoperative NIPE index monitoring could predict postoperative pain in neonates and infants. This prospective observational pilot study included neonates and infants undergoing elective day-surgical procedures (n = 50). Intraoperatively, NIPE indices at 0 (NIPE Linear regression documented an association between the NIPEm and postoperative FLACC score at 0 (r = 0.31, p = 0.03) and 10 min (r = 0.36, p = 0.01). No significant associations were observed for FLACC scores at 20 (r = 0.21, p = 0.2) and 30 min (r = 0.36, p > 0.9). Multiple regression analysis revealed that intraoperative NIPE The intraoperative NIPE index is predictive of pain in the immediate postoperative period. This association was lost at 20 min likely due to nursing intervention to administer analgesia. NIPE monitoring could be useful in facilitating postoperative pain management in infants. II. Study of Diagnostic Test.

Sections du résumé

BACKGROUND BACKGROUND
Pain assessment is essential for the administration of appropriate analgesia. Currently, clinicians use surrogate methods, such as heart rate or behavioural pain scales, to estimate pain in neonates and infants. The Newborn and Infant Parasympathetic Evaluation (NIPE™) monitor aims to provide an objective numeric value (NIPE index) of pain through a continuous assessment of the patient's parasympathetic activity. The aim of this study was to determine if the intraoperative NIPE index monitoring could predict postoperative pain in neonates and infants.
METHODS METHODS
This prospective observational pilot study included neonates and infants undergoing elective day-surgical procedures (n = 50). Intraoperatively, NIPE indices at 0 (NIPE
RESULTS RESULTS
Linear regression documented an association between the NIPEm and postoperative FLACC score at 0 (r = 0.31, p = 0.03) and 10 min (r = 0.36, p = 0.01). No significant associations were observed for FLACC scores at 20 (r = 0.21, p = 0.2) and 30 min (r = 0.36, p > 0.9). Multiple regression analysis revealed that intraoperative NIPE
CONCLUSION CONCLUSIONS
The intraoperative NIPE index is predictive of pain in the immediate postoperative period. This association was lost at 20 min likely due to nursing intervention to administer analgesia. NIPE monitoring could be useful in facilitating postoperative pain management in infants.
LEVEL OF EVIDENCE METHODS
II.
TYPE OF STUDY METHODS
Study of Diagnostic Test.

Identifiants

pubmed: 36646541
pii: S0022-3468(22)00780-1
doi: 10.1016/j.jpedsurg.2022.12.007
pii:
doi:

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

684-688

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Svetlana Ivanic (S)

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Lauren S Tong (LS)

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Ashleigh Laird (A)

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Atul Malhotra (A)

Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.

Ramesh M Nataraja (RM)

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Surgery, Faculty of Medicine, Nursing and Health Sciences., Monash University, Melbourne, Australia.

Cassandra Lang (C)

Department of Anaesthesia, Monash Medical Centre, Melbourne, Australia.

Maurizio Pacilli (M)

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Surgery, Faculty of Medicine, Nursing and Health Sciences., Monash University, Melbourne, Australia. Electronic address: maurizio.pacilli@monash.edu.

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