caa a22 4500 605510598 CHVBK 20210128100646.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10877-014-9600-8 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9600-8 The effects of low-dose ketamine on the analgesia nociception index (ANI) measured with the novel PhysioDoloris™ analgesia monitor: a pilot study [Elektronische Daten] [Laurent Bollag, Clemens Ortner, Srdjan Jelacic, Cyril Rivat, Ruth Landau, Philippe Richebé] The PhysioDoloris™ analgesia monitor assesses nociception effects on the autonomic nervous system by analyzing changes in heart rate variability (HRV). This non-invasive device analyses ECG signals and determines the analgesia nociception index (ANI), allowing for quantitative assessment of the analgesia/nociception balance in anesthetized patients. Ketamine, an analgesic adjuvant with sympathomimetic properties, has been shown to improve perioperative pain management. The purpose of this pilot study was to evaluate whether low-dose ketamine, due to its intrinsic effect on the sino-atrial node, affects HRV and, therefore, interferes with ANI measurements. This pilot study included 20 women undergoing abdominal hysterectomies. Anesthesia and analgesia were maintained with sevoflurane and fentanyl respectively, in a standardized manner. Five minutes after intubation, 0.5μgkg−1 of intravenous (i.v.) ketamine was administered. ANI, bispectral index (BIS), heart rate and blood pressure were recorded from the induction of anesthesia until 5min after skin incision. There was not any significant decrease in mean (±SD) ANI values after intubation (2.11±20.11, p=0.35) or i.v. ketamine administration (1.31±15.26, p=0.28). The mean (±SD) reduction in ANI values after skin incision was statistically significant (13.65±15.44, p=0.01), which is consistent with increased nociception. A single i.v. bolus of 0.5μgkg−1 ketamine did not influence the ANI values of 20 women under standardized general anesthesia conditions and absent noxious stimulation. These results suggest that the ANI derived from the PhysioDoloris™ analgesia monitor is feasible under such clinical conditions. Springer Science+Business Media New York, 2014 Analgesia monitoring nationallicence Equipment nationallicence PhysioDoloris™ analgesia monitor nationallicence Ketamine nationallicence Bollag Laurent Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut Ortner Clemens Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut Jelacic Srdjan Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut Rivat Cyril Institut des Neurosciences de Montpellier (INM), Université de Montpellier 2, Montpellier, France aut Landau Ruth Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut Richebé Philippe Department of Anesthesiology, University of Montreal, Montreal, QC, Canada aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/2(2015-04-01), 291-295 1387-1307 29:2<291 2015 29 10877 https://doi.org/10.1007/s10877-014-9600-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9600-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bollag Laurent Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Ortner Clemens Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Jelacic Srdjan Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Rivat Cyril Institut des Neurosciences de Montpellier (INM), Université de Montpellier 2, Montpellier, France aut NATIONALLICENCE 700 1- Landau Ruth Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Richebé Philippe Department of Anesthesiology, University of Montreal, Montreal, QC, Canada aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/2(2015-04-01), 291-295 1387-1307 29:2<291 2015 29 10877