Observational studyPloS one2016
Measurement of Heart Rate Variability to Assess Pain in Sedated Critically Ill Patients: A Prospective Observational Study.
Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05313789 (Analgesia Nociception Index for Pain Monitoring in Intensive Care Units), which is not on this map. Cited by 28 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analgesia Nociception Index for Pain Monitoring in Intensive Care Units
Who cites it
28 citing papers in PubMed.
- Early heart rate variability evaluation enables to predict ICU patients' outcome.Scientific reports · 2022Trial
- Comfort in palliative sedation (Compas): a transdisciplinary mixed method study protocol for linking objective assessments to subjective experiences.BMC palliative care · 2018Trial
- Article
- Agreement between analgesia nociception index (ANI) and surgical pleth index (SPI) in assessing nociception under varying systemic vascular resistance conditions.BMC anesthesiology · 2026Article
- From Iron Deficiency to Overload: A Missing Link in the Mechanisms of Cardiac Autonomic Nervous System Dysfunction.Journal of clinical medicine · 2026Review
- The ANI monitor's "Energy" variable detects autonomic state modification during general anesthesia, sedation and spinal anesthesia: a retrospective cohort study.Journal of clinical monitoring and computing · 2026Article
- Evaluation of the Analgesia Nociception Index (ANI) as an indicator of discomfort in deeply sedated, prepubescent patients.Journal of clinical monitoring and computing · 2026Article
- Heart Rate Variability Applications in Medical Specialties: A Narrative Review.Applied psychophysiology and biofeedback · 2025Review
- Pain assessment using the Analgesia Nociception Index in patients undergoing sedation: a systematic review and meta-analysis.The Korean journal of pain · 2025Article
- The validity and applications of the analgesia nociception index: a narrative review.Frontiers in surgery · 2023Review
- Prospective multicenter study of heart rate variability with ANI monitor as predictor of mortality in critically ill patients with COVID-19.Scientific reports · 2022Article
- Reliability of analgesia nociception index (ANI) and surgical pleth index (SPI) during episodes of bleeding - A pilot study.Indian journal of anaesthesia · 2022Article
- Letter to the Editor Regarding: "Neurophysiological Assessments During Continuous Sedation Until Death Put Validity of Observational Assessments Into Question: A Prospective Observational Study".Pain and therapy · 2022Article
- A One-Day Prospective National Observational Study on Sedation-Analgesia of Patients with Brain Injury in French Intensive Care Units: The SEDA-BIP-ICU (Sedation-Analgesia in Brain Injury Patient in ICU) Study.Neurocritical care · 2022Observational
- Pain Assessment in Intensive Care Unit: A Forgotten Entity or a Quality Indicator?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study.Brain sciences · 2021Article
- Influence of Sliding Time Window Size Selection Based on Heart Rate Variability Signal Analysis on Intelligent Monitoring of Noxious Stimulation under Anesthesia.Neural plasticity · 2021Article
- Newborn infant parasympathetic evaluation for the assessment of analgosedation adequacy in infants treated by mechanical ventilation - a multicenter pilot study.Archives of medical science : AMS · 2021Article
- Observational
- Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population.European journal of pediatrics · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe analgesia nociception index (ANI) assesses the relative parasympathetic tone as a surrogate for antinociception/nociception balance in sedated patients. The aim of this study is to determine the effectiveness of ANI in detecting pain in deeply sedated critically ill patients.
methodsThis prospective observational study was performed in two medical ICUs. All patients receiving invasive mechanical ventilation and deep sedation were eligible. In all patients, heart rate and ANI were continuously recorded using the Physiodoloris® device during 5 minutes at rest (T1), during a painful stimulus (T2), and during 5 minutes after the end of the painful stimulus (T3). The chosen painful stimulus was patient turning for washstand. Pain was evaluated at T2, using the behavioral pain scale (BPS). The primary objective was to determine the effectiveness of ANI in detecting pain. Secondary objectives included the impact of norepinephrine on the effectiveness of ANI in detecting pain, and the correlation between ANI and BPS.
resultsForty-one patients were included. ANI was significantly lower at T2 (Med (IQR) 69(55-78)) compared with T1 (85(67-96), p<0.0001), or T3 (81(63-89), p<0.0001). Similar results were found in the subgroups of patients with (n = 21) or without (n = 20) norepinephrine. ANI values were significantly higher in patients with norepinephrine compared with those without norepinephrine at T1, and T2. No significant correlation was found between ANI and BPS at T2.
conclusionsANI is effective in detecting pain in deeply sedated critically ill patients, including those patients treated with norepinephrine. No significant correlation was found between ANI and BPS.
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