ArticleCureus2025
Relationship Between Local Anesthetic Infiltration Pain Before Spinal Anesthesia and the Analgesia Nociception Index for Women Undergoing Elective Cesarean Delivery: A Prospective Observational Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis: a randomized controlled trial utilizing high-frequency variability index.Journal of clinical monitoring and computing · 2026Article
- Dexmedetomidine attenuates nociceptive responses compared with propofol during intravenous sedation for dental surgery: a prospective observational study.Journal of dental anesthesia and pain medicine · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Heart rate variability-derived indices, such as the high-frequency vitality index (HFVI)/analgesia nociception index (ANI), have been proposed as objective pain assessment tools. However, their ability to predict pain perception during local anesthetic injection (LAI) remains unclear. Methods This single-center observational study included 44 pregnant women scheduled for cesarean delivery under spinal anesthesia. The HFVI/ANI was measured for five minutes before LAI using a Root® monitor (Masimo Corp., Irvine, CA). The primary outcome measure was the mean HFVI/ANI before LAI during spinal anesthesia. The secondary outcomes included the area under the receiver operating characteristic curve to determine the cut-off and predictive accuracy. Results There was no significant difference in the pre-LAI HFVI/ANI between the patients with visual numeric rating scale (VNRS) of ≤3 and those with VNRS of >3 (HFVI: 64.25 ± 11.8 vs. 62.64 ± 12.3, P = 0.66). ROC analysis revealed poor predictive ability (AUC = 0.54, 95% CI: 0.36-0.72). No significant correlation was found between HFVI/ANI and VNRS. Conclusion Pre-LAI HFVI/ANI values were not associated with pain perception during LAI during cesarean delivery. Further studies are needed to explore optimal indicators for HFVI/ANI-based pain assessment.
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