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- Title
Pain monitoring in intensive care: How does the nociception level index affect treatment and prognosis? A randomized, controlled, double-blind trial.
- Authors
Çalışkan, Berna; Besir, Zeki; Sen, Öznur
- Abstract
BACKGROUND: Effective pain management is vital in critical care settings, particularly post-surgery. Clinicians should maintain objective and efficient standards to assess pain in a patient-centered manner, in order to effectively manage this complex issue. A newer technology, the nociception level (NOL) index, shows promise in achieving this task through its multi-parameter evaluation. METHODS: This study was a prospective, controlled, randomized trial involving two groups of patients (n=30 each) in a diverse intensive care unit. Participants were over 18 years old with American Society of Anesthesiology scores ranging from I to III and were scheduled for critical care follow-up after general anesthesia. All subjects followed a standard analgesia protocol that included rescue analgesia. Drug administration was guided by a numeric rating scale and the critical care pain observation tool in the Control Group, while it was guided by nociception level index monitoring in the NOL Group. RESULTS: Pain scores between the two groups did not significantly differ. However, within the NOL Group, pain scores and nociception values displayed a strong positive correlation. Notably, total analgesic consumption was significantly lower in the NOL Group (p=0.036). CONCLUSION: Monitoring pain using the nociception level index is an effective method for detecting pain compared to standard pain scores utilized in critical care. Its guidance facilitates personalized analgesic titration. Additionally, the potential of nociception level index guidance to reduce the duration of intensive care and hospital stays may be linked to its effects on delirium, a connection that awaits further exploration in future studies.
- Subjects
POSTOPERATIVE pain treatment; PAIN measurement; POSTOPERATIVE pain; STATISTICAL sampling; NOCICEPTIVE pain; RANDOMIZED controlled trials; DESCRIPTIVE statistics; ANALGESICS; PATIENT-centered care; DELIRIUM; PAIN management; INTENSIVE care units; PAIN; COGNITION disorders; PATIENT monitoring; LENGTH of stay in hospitals; THOUGHT &; thinking
- Publication
Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi, 2024, Vol 30, Issue 6, p415
- ISSN
1306-696X
- Publication type
Article
- DOI
10.14744/tjtes.2024.95533