Observational studyJournal of clinical monitoring and computing2026
Effect of preoperative β-blocker use on Analgesia-Nociception Index during laparoscopic cholecystectomy.
Observational study in Journal of clinical monitoring and computing, 2026. 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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Abstract
Background The Analgesia-Nociception Index (ANI), derived from heart rate variability, reflects parasympathetic activity and is used to assess intraoperative nociception. β-blockers modulate autonomic tone and heart rate variability and may influence responses to nociceptive stimuli. This study investigated whether preoperative β-blocker use was associated with altered intraoperative ANI dynamics during laparoscopic cholecystectomy. Method The data of 49 patients with hypertension who underwent elective laparoscopic cholecystectomy under a standardized propofol-remifentanil anesthetic protocol were analyzed in this prospective observational study. Patients were classified according to chronic β-blocker use (β-blocker group, n = 24; non-β-blocker group, n = 25). Four predefined nociceptive stimuli were applied under stable anesthetic conditions. The minimum ANI value within 2 min after each stimulus (ANI_min) and the change from the pre-stimulus value (ΔANI) were analyzed using repeated-measures analysis of variance. Results Repeated-measures ANOVA demonstrated a significant main effect of time, indicating a consistent decrease in ANI in response to standardized nociceptive stimuli. No significant time × group interaction or main effect of group was observed for ANI_min or ΔANI. The temporal patterns and magnitudes of ANI changes were comparable between groups across all predefined time points. Conclusions Preoperative β-blocker therapy did not substantially alter stimulus-related ANI dynamics during laparoscopic cholecystectomy under propofol-remifentanil anesthesia. These findings suggest that ANI may remain interpretable as a dynamic within-patient autonomic response in chronically β-blocked patients under these anesthetic conditions.
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