Evaluation of the Analgesia Nociception Index and videopupillometry to predict post-tonsillectomy morphine requirements in children
Analgesia Nociception Index
FLACC scale
analgesia
paediatric anaesthesia
tonsillectomy
videopupillometry
Journal
BJA open
ISSN: 2772-6096
Titre abrégé: BJA Open
Pays: England
ID NLM: 9918419157906676
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
09
05
2022
revised:
17
06
2022
accepted:
20
06
2022
medline:
17
8
2023
pubmed:
17
8
2023
entrez:
17
8
2023
Statut:
epublish
Résumé
Tonsil surgery causes significant and challenging postoperative pain. The Analgesia Nociception Index (ANI) and videopupillometry are two techniques of interest to monitor nociception in adults and may predict postoperative morphine requirements. We hypothesised that these techniques could predict the need for morphine after tonsillectomy in children. The main objective was to assess the prognostic significance of ANI and videopupillometry, measured at the end of surgery, on morphine consumption determined by a Face, Legs, Activity, Cry, Consolability (FLACC) scale score >3 in the Post Anesthesia Care Unit (PACU). A single-centre, prospective, interventional study evaluating children between 2 and 7 yr old undergoing tonsil surgery was performed. ANI and videopupillometry with tetanic stimulation were measured under general anaesthesia 4 min after the end of the surgical procedure. Each child was evaluated every 10 min by a nurse using the FLACC scale in the PACU and blinded to the measurements performed in the operating theatre. Eighty-nine children were analysed and 39 (44%) received morphine in the PACU. Neither ANI values nor videopupillometry values were predictive of postoperative morphine consumption (areas under the receiver operating characteristic curve 0.54, 95% confidence interval [CI; 0.42-0.65], and Neither ANI nor videopupillometry performed at the end of surgery can predict morphine consumption in the PACU in children undergoing tonsillectomy.
Sections du résumé
Background
UNASSIGNED
Tonsil surgery causes significant and challenging postoperative pain. The Analgesia Nociception Index (ANI) and videopupillometry are two techniques of interest to monitor nociception in adults and may predict postoperative morphine requirements. We hypothesised that these techniques could predict the need for morphine after tonsillectomy in children. The main objective was to assess the prognostic significance of ANI and videopupillometry, measured at the end of surgery, on morphine consumption determined by a Face, Legs, Activity, Cry, Consolability (FLACC) scale score >3 in the Post Anesthesia Care Unit (PACU).
Methods
UNASSIGNED
A single-centre, prospective, interventional study evaluating children between 2 and 7 yr old undergoing tonsil surgery was performed. ANI and videopupillometry with tetanic stimulation were measured under general anaesthesia 4 min after the end of the surgical procedure. Each child was evaluated every 10 min by a nurse using the FLACC scale in the PACU and blinded to the measurements performed in the operating theatre.
Results
UNASSIGNED
Eighty-nine children were analysed and 39 (44%) received morphine in the PACU. Neither ANI values nor videopupillometry values were predictive of postoperative morphine consumption (areas under the receiver operating characteristic curve 0.54, 95% confidence interval [CI; 0.42-0.65], and
Conclusions
UNASSIGNED
Neither ANI nor videopupillometry performed at the end of surgery can predict morphine consumption in the PACU in children undergoing tonsillectomy.
Identifiants
pubmed: 37588574
doi: 10.1016/j.bjao.2022.100024
pii: S2772-6096(22)00023-5
pmc: PMC10430817
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100024Informations de copyright
© 2022 The Author(s).
Références
Psychophysiology. 1999 Jan;36(1):44-52
pubmed: 10098379
Pediatr Emerg Care. 2013 Jan;29(1):17-20
pubmed: 23283256
J Pediatr Psychol. 2008 Oct;33(9):911-5
pubmed: 16675715
Br J Anaesth. 2003 Sep;91(3):347-52
pubmed: 12925472
Anesth Analg. 2019 Mar;128(3):467-474
pubmed: 30198934
Br J Anaesth. 2015 Dec;115(6):890-5
pubmed: 26582849
Pediatr Emerg Care. 2012 Dec;28(12):1281-96
pubmed: 23187981
Curr Opin Anaesthesiol. 2009 Jun;22(3):388-95
pubmed: 19434787
Cochrane Database Syst Rev. 2017 Aug 22;8:CD004619
pubmed: 28828761
Pediatr Nurs. 1997 May-Jun;23(3):293-7
pubmed: 9220806
Br J Anaesth. 2015 Feb;114(2):345-6
pubmed: 25596223
Anesth Analg. 2017 Mar;124(3):915-921
pubmed: 27941575
Anaesthesia. 2021 Jul;76(7):947-961
pubmed: 33201518
PLoS One. 2016 Apr 27;11(4):e0154155
pubmed: 27120174
Br J Anaesth. 2014 Apr;112(4):715-21
pubmed: 24322571
J Pharm Sci. 1984 Oct;73(10):1496-7
pubmed: 6502506
Anesth Analg. 2018 Jan;126(1):70-77
pubmed: 28107273
J Clin Monit Comput. 2012 Aug;26(4):289-94
pubmed: 22454275
Pediatrics. 2012 May;129(5):e1343-7
pubmed: 22492761
Pain. 2015 Nov;156(11):2132-2151
pubmed: 26207651
Br J Anaesth. 2012 Apr;108(4):648-54
pubmed: 22265901
Pediatrics. 2015 Feb;135(2):307-13
pubmed: 25624387
Anesth Analg. 2001 Nov;93(5):1127-31
pubmed: 11682380
Otolaryngol Head Neck Surg. 2019 Feb;160(2):187-205
pubmed: 30921525
Pain. 1998 Mar;75(1):37-45
pubmed: 9539672
Natl Health Stat Report. 2009 Jan 28;(11):1-25
pubmed: 19294964