Pain monitoring helps assess the effectiveness of opioid-sparing approaches during surgery
2021-05-25
(Press-News.org) A new study has shown that effective opioid-sparing anaesthesia with dexmedetomidine can be guided with NOL pain monitoring technology (Medasense, Israel). The study showed that the NOL monitor is able to detect the effect of dexmedetomidine on the patient's pain response and enable administration of less intraoperative opioids.
Patients undergoing anaesthesia for surgical procedures are traditionally treated with opioids (e.g., remifentanil) to manage intraoperative pain. But clinicians are progressively seeking to reduce opioid use by introducing multimodal analgesia, a technique that involves a combination of medications that often includes a central alpha agonist, such as dexmedetomidine. This approach may offer pain relief, offset potentially adverse effects of individual drugs in larger doses and enable a reduction of opioid use during surgery.1 With this strategy, however, clinicians are not always able to predict whether the impact of the drug combination will be effective or excessive.
The current study addressed this challenge in multimodal analgesia and examined its effectiveness by monitoring pain response (nociception) levels in patients with the NOL monitoring system.
NOL monitoring is a non-invasive multi-sensor AI technology that provides a reliable index to objectively detect and quantify the patient's physiological response to painful stimuli during anaesthesia, when patients can't communicate. This index guides the clinical team in tailored pain medication for each patient. Earlier studies have shown that the NOL index outperforms other indexes2 for monitoring of pain response to surgical stimuli and that NOL-guided analgesia has resulted in reduced intraoperative opioid consumption3 as well as less pain after surgery.4
Led by Dr. Sean Coeckelenbergh of Erasme University Hospital in Brussels, Belgium, the new randomised controlled study examined 58 patients undergoing NOL-guided analgesia. Patients were randomised to receive either placebo or low-dose dexmedetomidine and both groups received intraoperative antinociception with a target-controlled infusion of remifentanil guided by the NOL index. The study, just published in the European Journal of Anaesthesiology,5 has shown that NOL can provide an objective reflection of dexmedetomidine's effects, helping the clinician in the decision-making process when applying multimodal pain relief, with the potential for significant opioid sparing during surgery.
"Multimodal anaesthesia has benefits, but it is limited in that we often do not know the exact depth of anaesthesia and antinociception," explains Dr. Coeckelenbergh. "The NOL index offers us a new way to quantify nociception when combining alpha agonists and opioids," he says.
INFORMATION:
About Medasense and NOL Technology
Medasense offers a breakthrough technology that enables clinicians to optimize and personalize pain control and avoid overmedication. Medasense's flagship product, the PMD-200™ with its NOL® index, is a unique platform that objectively monitors and quantifies the patient's pain response by means of artificial intelligence and a proprietary non-invasive sensor platform.
The PMD-200 is used to optimize pain management in critical care and operating rooms settings, where patients are unable to communicate.
Clinical studies have demonstrated its impact on patient safety and outcomes, including opioid sparing and less pain reported by patients following surgery.
The PMD-200 is distributed in Europe by Medtronic, is cleared for marketing also in Canada, Latin America, Israel, Australia and the United Arab Emirates, and enables connectivity with Philips patient monitors.
1. Kehlet H, Dahl JB. The value of 'multimodal' or 'balanced analgesia' in postoperative pain treatment. Anesth Analg 1993; 77: 1048-1056.
2. Edry R, Recea V, Dikust Y, Sessler DI. Preliminary intraoperative validation of the nociception level index: a noninvasive nociception monitor. Anesthesiology 2016; 125:193-203.
3. Meijer FS, Martini CH, Broens S, et al. Nociception-guided versus standard care during remifentanil-propofol anesthesia: a randomized controlled trial. Anesthesiology 2019; 130:745-755.
4. Meijer, F. et al. Reduced postoperative pain using Nociception Level-guided fentanyl dosing during sevoflurane anaesthesia: a randomised controlled trial. British Journal of Anaesthesia, 2020;125(6):1070-1078.
5. Coeckelenbergh S, Doria S, Patricio D, Perrin L, Engelman E, Rodriguez A, Di Marco L, Van Obbergh L, Estebe JP, Barvais L, Kapessidou P. Effect of dexmedetomidine on Nociception Level Index-guided remifentanil antinociception: A randomised controlled trial. Eur J Anaesthesiol. 2021 May 1;38(5):524-533. doi: 10.1097/EJA.0000000000001402. PMID: 33259449.
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
2021-05-25
Professor UEYAMA Takehiko (Biosignal Research Center, Kobe University) and the inner ear research group (Kyoto Prefectural University of Medicine) have identified the cell types in the inner ear cochlea (*1) responsible for the production of superoxide (Nox3*2-expressing cells). They achieved this by using genetically modified mice that they developed. The researchers discovered that these superoxide-producing cells increase in number in response to aging, noise damage, and ototoxic drugs, thus causing age-related, noise-induced and drug-induced hearing loss. In addition, they were able to suppress the onset of these three types of ...
2021-05-25
HERSHEY, Pa. -- Screening and testing for sexually transmitted infections (STIs) decreased by 63% for men and 59% for women during the early months of the COVID-19 pandemic, according to a new study led by Penn State and Quest Diagnostics researchers. The researchers said this may be the result of restrictions placed on direct patient care and shifts to telehealth and could lead to a possible future surge in STI cases.
This is the first national study to explore the impact of the pandemic on STIs since the Centers for Disease Control and Prevention ...
2021-05-25
Computational tools are indispensable in almost all scientific disciplines. Especially in cases where large amounts of research data are generated and need to be quickly processed, reliable, carefully developed software is crucial for analyzing and correctly interpreting such data. Nevertheless, scientific software can have quality quality deficiencies. To evaluate software quality in an automated way, computer scientists at Karlsruhe Institute of Technology (KIT) and Heidelberg Institute for Theoretical Studies (HITS) have designed the SoftWipe tool.
"Adherence to coding standards is rarely considered in scientific software, although it can even lead to incorrect scientific results," says ...
2021-05-25
BOSTON - Physical activity that conforms to medical and health association guidelines is associated with a lower risk of atrial fibrillation (Afib) and stroke, according to a study by researchers at Massachusetts General Hospital (MGH), who analyzed nearly 100,000 individuals equipped with wrist-worn accelerometers to measure their movement. The researchers' findings suggest that data from wearables, including a new generation of devices with sensors that allow for Afib detection, could provide an opportunity for the public health community to promote moderate physical activity as an effective way to improve health outcomes. The study ...
2021-05-25
Digital medicine is opening up entirely new possibilities. For example, it can detect tumors at an early stage. But the effectiveness of new AI algorithms depends on the quantity and quality of the data used to train them.
To maximize the data pool, it is customary to share patient data between clinics by sending copies of databases to the clinics where the algorithm is being trained. For data protection purposes, the material usually undergoes anonymization and pseudonymization processes - a procedure that has also come in for criticism. "These processes have often proven inadequate in terms of protecting patients' health data," says Daniel Rueckert, ...
2021-05-25
From shamans and mystics to cult leaders and divine kings, why have people throughout history accorded high status to people believed to have supernatural powers?
According to a study led by researchers from the University of Oxford, this tendency to attribute social dominance to such individuals is rooted in early development.
As part of the study, 48 infants aged 12 to 16 months watched a series of animated videos in which two characters competed for a reward. In each scenario, one character displayed physically counterintuitive methods of making ...
2021-05-25
In a new publication from Opto-Electronic Advances; DOI https://doi.org/10.29026/oea.2021.200077, Researchers led by Professor Jeongyong Kim at the Department of Energy Science, Sungkyunkwan University, Suwon, Republic of Korea review light-emitting MXene quantum dots.
MXenes have found wide-ranging applications in energy storage devices, sensors, catalysis, etc. owing to their high electronic conductivity and wide range of optical absorption. However, the absence of semiconducting MXenes has limited their applications related to light emission.
Extensively reviewing current relevant research, the authors summarise recent advances in MXene quantum dot (MQD) research on the synthesis, optical properties and applications of MQDs as light emitting quantum materials. Research ...
2021-05-25
Graphene is an ultrathin material characterized by its ultrasmall bending modulus, superflimsiness. Now the researchers at the Nanoscience Center of the University of Jyväskylä have demonstrated how an experimental technique called optical forging can make graphene ultrastiff, increase its stiffness by several orders of magnitude. The research was published in npj 2D Materials and Applications in May 2021.
Graphene is an atomically thin carbon material loaded with excellent properties, such as large charge carrier mobility, superb thermal conductivity, and high ...
2021-05-25
When it comes to distinguishing a healthy cell from an infected one that needs to be destroyed, the immune system's killer T cells sometimes make mistakes.
This discovery, described today in eLife, upends a long-held belief among scientists that T cells were nearly perfect at discriminating friend from foe. The results may point to new ways to treat autoimmune diseases that cause the immune system to attack the body, or lead to improvements in cutting-edge cancer treatments.
It is widely believed that T cells can discriminate perfectly between infected cells and healthy ones based on how tightly they are able to bind to molecules called antigens ...
2021-05-25
About 14 billion years ago, our universe changed from being a lot hotter and denser to expanding radically - a process that scientists have named 'The Big Bang'.
And even though we know that this fast expansion created particles, atoms, stars, galaxies and life as we know it today, the details of how it all happened are still unknown.
Now a new study performed by researchers from University of Copenhagen reveals insights on how it all began.
"We have studied a substance called Quark-Gluon Plasma that was the only matter, which existed during the first microsecond ...
LAST 30 PRESS RELEASES:
[Press-News.org] Pain monitoring helps assess the effectiveness of opioid-sparing approaches during surgery
