Related Experiment Video
Updated: May 10, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
The Analgesia Nociception Index's Performance During Remimazolam-Based General Anesthesia: A Prospective
Joohyun Lee1, Jung-Min Yi2, Young Joo1
1Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University, Ilsan 13496, Republic of Korea.
Abstract:
Background and Objectives: The Analgesia Nociception Index (ANI), a surrogate marker derived from heart rate variability (HRV) analysis, has been validated for assessing the balance between antinociception and nociception during propofol anesthesia. The ANI continuously monitors this balance, with values above 50 indicating optimal analgesia. By adjusting analgesic administration based on ANI values, anesthesiologists can provide more personalized intraoperative pain control. Remimazolam, a novel benzodiazepine anesthetic lacking intrinsic analgesic properties, exhibits distinct HRV patterns compared to propofol. Considering these differences, the validity of the ANI during remimazolam anesthesia remains uncertain. We evaluated the validity of the ANI by assessing its ability to detect nociceptive stimuli during remimazolam anesthesia. Materials and Methods: In total, 28 patients were administered general anesthesia using remimazolam and remifentanil. We evaluated changes in the ANI before and after tetanic stimulation. In addition, we investigated the association between hemodynamic responses during surgical incisions and changes in the ANI. Results: Tetanic stimulation resulted in a significant (p < 0.001) reduction in the ANI, from 62.0 (interquartile range [IQR] 50.5-76.0) to 44.0 (IQR 37.0-55.5). Of the 13 patients who experienced hemodynamic responses during surgical incision, the ANI significantly decreased from 63.2 ± 13.6 to 36.9 ± 13.8 following noxious surgical stimulation (p < 0.001). Conclusions: The ANI reflects the dynamic equilibrium between antinociception and nociception during remimazolam-based general anesthesia.
More Related Videos
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
07:23Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
Published on: July 29, 2014
Related Concept Videos
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Stages of General Anesthesia
Parenteral Anesthetics: Overview
Inhalational Anesthetics: Overview
Analgesia and Pain Management
Opioid Analgesics: Synthetic and Semisynthetic Opioids