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Measurement of Heart Rate Variability to Assess Pain in Sedated Critically Ill Patients: A Prospective Observational Study

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  • Céline Broucqsault-Dédrie
  • Julien De Jonckheere
  • Mathieu Jeanne
  • Saad Nseir

Abstract

Introduction: The analgesia nociception index (ANI) assesses the relative parasympathetic tone as a surrogate for antinociception/nociception balance in sedated patients. The aim of this study is to determine the effectiveness of ANI in detecting pain in deeply sedated critically ill patients. Methods: This prospective observational study was performed in two medical ICUs. All patients receiving invasive mechanical ventilation and deep sedation were eligible. In all patients, heart rate and ANI were continuously recorded using the Physiodoloris® device during 5 minutes at rest (T1), during a painful stimulus (T2), and during 5 minutes after the end of the painful stimulus (T3). The chosen painful stimulus was patient turning for washstand. Pain was evaluated at T2, using the behavioral pain scale (BPS). The primary objective was to determine the effectiveness of ANI in detecting pain. Secondary objectives included the impact of norepinephrine on the effectiveness of ANI in detecting pain, and the correlation between ANI and BPS. Results: Forty-one patients were included. ANI was significantly lower at T2 (Med (IQR) 69(55–78)) compared with T1 (85(67–96), p

Suggested Citation

  • Céline Broucqsault-Dédrie & Julien De Jonckheere & Mathieu Jeanne & Saad Nseir, 2016. "Measurement of Heart Rate Variability to Assess Pain in Sedated Critically Ill Patients: A Prospective Observational Study," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-11, January.
    • Handle: RePEc:plo:pone00:0147720
    DOI: 10.1371/journal.pone.0147720
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