Observational studyJournal of clinical monitoring and computing2025
Assessment of intraoperative high frequency variability index as a predictor of postoperative pain after open liver or pancreatic surgery under combined general and epidural anesthesia: a prospective observational study.
Observational study in Journal of clinical monitoring and computing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
7 authors.
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Abstract
The aim of the present study was to investigate the utility of the intraoperative high frequency variability index (HFVI) / Analgesia Nociception Index (ANI) for predicting postoperative pain in patients undergoing open liver or pancreatic surgery under combined general and epidural anesthesia, with a particular focus on HFVI/ANI measured immediately before extubation. We investigated whether maximum postoperative pain at rest and postoperative morphine consumption were associated with intraoperative HFVI/ANI values, including those measured immediately before extubation, the mean intraoperative values, the difference between values immediately before and 5 min after the first administration of local anesthetics via epidural catheter, and the difference between values immediately before and 5 min after the start of surgery. We analyzed the data obtained from 52 patients and found that HFVI/ANI measured immediately before extubation showed a limited but statistically significant association with postoperative pain at rest. However, receiver operating characteristic curve analysis failed to demonstrate clinically useful predictive performance of HFVI/ANI for postoperative pain defined as Numerical Rating Scale > 3 or > 7. In addition, no association was observed between intraoperative HFVI/ANI measured at any time point and postoperative morphine consumption. The present study demonstrated that intraoperative HFVI/ANI may reflect postoperative pain levels to a limited extent, particularly when measured immediately before extubation, but lacks sufficient accuracy to be used as a standalone predictor of postoperative pain.
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