Trial reportJournal of clinical monitoring and computing2023
Reduced postoperative pain in patients receiving nociception monitor guided analgesia during elective major abdominal surgery: a randomized, controlled trial.
Trial report in Journal of clinical monitoring and computing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Impact of Nociceptive-Level (NOL) Intraoperative Guided Fentanyl Analgesia Versus Standard Clinical Care (SCC) for Elective Major Abdominal Surgery
Virtual Reality as a Strategy for Intra-operatory Anxiolysis and Pharmacological Sparing in Patients Undergoing Breast Surgeries : the V-RAPS Randomized Controlled Trial
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of Postoperative Opioid Consumption, Pain and Complications Following Intraoperative Autonomic Nervous System-Based Nociception Monitoring.European journal of pain (London, England) · 2026Pooled it
- Machine learning-augmented interventions in perioperative care: a systematic review and meta-analysis.British journal of anaesthesia · 2024Pooled it
- Artificial intelligence-assisted interventions for perioperative anesthetic management: a systematic review and meta-analysis.BMC anesthesiology · 2024Pooled it
- Nociception level index monitoring in intensive care: pain awareness in pressure ulcer care in unconscious patients: a randomized controlled pilot study.Irish journal of medical science · 2025Trial
- Nociception level index-directed superficial parasternal intercostal plane block vs erector spinae plane block in open-heart surgery: a propensity matched non-inferiority clinical trial.Journal of clinical monitoring and computing · 2025Trial
- Effect of nociception level-directed analgesic management on opioid usage in robot-assisted laparoscopic radical prostatectomy: a single-center, single-blinded, randomized controlled trial.Journal of anesthesia · 2024Trial
- Pain monitoring in intensive care: How does the nociception level index affect treatment and prognosis? A randomized, controlled, double-blind trial.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Trial
- Nociception Control of Bilateral Single-Shot Erector Spinae Plane Block Compared to No Block in Open Heart Surgery-A Post Hoc Analysis of the NESP Randomized Controlled Clinical Trial.Medicina (Kaunas, Lithuania) · 2023Trial
- Beyond the Numerical Rating Scale: Comprehensive Pain Assessment in the Post-Anesthesia Care Unit.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2026Article
- Development and validation of risk factors prediction model for hypoxemia in the PACU patients after major abdominal surgery: a retrospective study.Frontiers in medicine · 2026Article
- Nociception level index response to pacemaker stimulation.Journal of clinical monitoring and computing · 2025Observational
- Objective monitoring of acute pain and nociception in anaesthesia and intensive care: evidence and applications.Anaesthesiology intensive therapy · 2025Review
- Utility of the nociception level index to monitor intraoperative nociception and predict acute postoperative pain in thoracic surgery.Journal of clinical monitoring and computing · 2025Observational
- From Data to Decisions: Harnessing Multi-Agent Systems for Safer, Smarter, and More Personalized Perioperative Care.Journal of personalized medicine · 2025Review
- EXPRESS: Dehydrocorydaline can be a suitable candidate for analgesic purposes: a review on the current preclinical evidence.Molecular pain · 2025Review
- Review
- Just another tool in their repertoire: uncovering insights into public and patient perspectives on clinicians' use of machine learning in perioperative care.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Analysis of the Effects of Epidural Anesthesia on the Nociception Level Index (NOLJournal of clinical medicine · 2024Article
- Nociception level index variations in ICU: curarized vs non-curarized patients - a pilot study.Journal of anesthesia, analgesia and critical care · 2024Article
- Initial Validation of the NOL Nociception Level IndexMedical devices (Auckland, N.Z.) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The Nociception Level index (NOL™) is a multiparameter index, based on artificial intelligence for the monitoring of nociception during anesthesia. We studied the influence of NOL-guided analgesia on postoperative pain scores in patients undergoing major abdominal surgery during sevoflurane/fentanyl anesthesia. This study was designed as a single-center, prospective randomized, controlled study. After Institutional Review Board approval and written informed consent, 75 ASA 1-3 adult patients undergoing major abdominal surgery, were randomized to NOL-guided fentanyl dosing (NOL) or standard care (SOC) and completed the study. The sevoflurane target MAC range was 0.8-1.2. In the NOL-guided group (N = 36), when NOL values were > 25 for at least 1 min, a weight adjusted fentanyl bolus was administered. In the control group (N = 39) fentanyl administration was based on hemodynamic indices and clinician judgement. After surgery, pain, was evaluated using the Numerical Rating Scale (NRS) pain scale, ranging from 0 to 10, at 15 min intervals for 180 min or until patient discharge from the PACU. Median postoperative pain scores reported were 3.0 [interquartile range 0.0-5.0] and 5.0 [3.0-6.0] at 90 min in NOL-guided and control groups respectively (Bootstrap corrected actual difference 1.5, 95% confidence interval 0.4-2.6). There was no difference in postoperative morphine consumption or intraoperative fentanyl consumption. Postoperative pain scores were significantly improved in nociception level index-guided patients. We attribute this to more objective fentanyl dosing when timed to actual nociceptive stimuli during anesthesia, contributing to lower levels of sympathetic activation and surgical stress. Clinicaltrials.gov identifier: NCT03970291 date of registration May 31, 2019.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.