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Master Thesis

La nociception peropératoire, évaluée par l'Analgesia Nociception Index (ANI), peut-elle prédire la douleur postopératoire en chirurgie cervicothyroïdienne ?

Abstract : Background: management of perioperative pain and nociception is the core of the anesthesiologist’s role. However, their underlying pathophysiological mechanisms remains incompletely known. Moreover, the impact of intraoperative control of nociception on postoperative pain has not been extensively investigated. We proposed to evaluate the relationship between intraoperative nociception, measured by Analgesia Nociception Index (ANI) monitoring, and postoperative pain. Methods: after approval by our ethical committee, a total of 70 patients undergoing cervicothyroid surgery were retrospectively included in this study. ANI data were recorded from surgical incision to closure and were correlated to the postoperative pain outcomes (numeric rating scale during the 24 first hours, total opioid consumption). ANI data included the time or the area under the curve below the nociception levels given by the manufacturer or below the patient's ANI baseline value. In addition, subgroups of patients receiving or not Opioid-Free anesthesia (OFA) were compared. Results: whatever the criteria analyzed, the intraoperative ANI-derived nociception values were not correlated to pain outcomes. Patients receiving OFA had lower levels of pain (3 [2-4] vs. 4 [3-5], p-value 0.01), while the ANI monitoring showed higher nociception levels that of patients not receiving OFA. Conclusion: intraoperative nociception quantified by ANI monitoring showed no correlation with postoperative pain and opioid consumption. Those findings are in the line of the hypothesis of a “disconnection” between intraoperative nociception and postoperative pain, which is one of the basic principles of OFA.
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https://dumas.ccsd.cnrs.fr/dumas-03389507
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Submitted on : Thursday, October 21, 2021 - 9:01:27 AM
Last modification on : Wednesday, December 8, 2021 - 3:55:31 AM
Long-term archiving on: : Saturday, January 22, 2022 - 6:20:22 PM

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  • HAL Id : dumas-03389507, version 1

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Pierre-Lou Cucuphat. La nociception peropératoire, évaluée par l'Analgesia Nociception Index (ANI), peut-elle prédire la douleur postopératoire en chirurgie cervicothyroïdienne ?. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03389507⟩

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