Pain Monitoring in Intensive Care: The Impact of Nociception Level Index on Treatment and Prognosis
Background
Effective pain management is crucial in critical care, especially after surgery. Clinicians need objective and efficient methods to assess pain in a patient-centered manner. The nociception level (NOL) index offers promise in achieving this through its multi-parameter evaluation.
Methods
This study involved a prospective, controlled, randomized trial with two groups of patients in a diverse intensive care unit. Participants were over 18 years old with American Society of Anesthesiology scores ranging from I to III and were scheduled for critical care follow-up after general anesthesia. The Control Group followed a standard analgesia protocol guided by a numeric rating scale and the critical care pain observation tool, while the NOL Group’s drug administration was guided by NOL monitoring.
Results
Pain scores did not significantly differ between the two groups. However, within the NOL Group, pain scores and NOL values showed a strong positive correlation. Importantly, total analgesic consumption was significantly lower in the NOL Group.
Conclusion
Monitoring pain using the NOL index is an effective method for detecting pain compared to standard pain scores in critical care. Its guidance facilitates personalized analgesic titration. Additionally, the potential of NOL index guidance to reduce the duration of intensive care and hospital stays may be linked to its effects on delirium, a connection that awaits further exploration in future studies.
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