Comparison of Postoperative Nociception Between NOL-guided and Standard Intraoperative Analgesia Based on Fentanyl
Status:
Recruiting
Trial end date:
2022-11-30
Target enrollment:
Participant gender:
Summary
Pain is defined as an unpleasant sensory and emotional conscious experience, associated with
actual or potential tissue damage. Nociception is the sympathetic response to noxious stimuli
during unconsciousness. The appearance of different forms of chronic pain results from
sensitization of both peripheral and central neural circuits of pain, which involves
inflammatory mechanisms both at a systemic level and specifically in the peripheric and
central nervous system, as observed through elevation of specific neuroinflammatory
mediators, such as MCP-1, IL-1, IL-1b, and IL-10. Clinically, this sensitization expresses as
hyperalgesia and allodynia, which increase postoperative pain and morbidity, but also induce
permanent modifications in the nociceptive system. These effects may be ameliorated by
adequately adjusting intraoperative analgesia through use of nociception/analgesia balance
monitors, of which Nociception Level Index (NOL) shows convenient characteristics and
promising results from previous studies.
Objectives: The goal of our study is to assess the utility of NOL index monitoring against
standard care for Fentanyl-based analgesia by measuring postoperative pain, sensorial
thresholds and inflammatory markers related to nociception.
Hypothesis: The use of NOL index to guide the intraoperative analgesia will produce less
postoperative pain, hyperalgesia, allodynia, and neuroinflammation.