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22-10-2022 | Opioids | Review Article

Analgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone

Authors: Keisuke Yoshida, Shinju Obara, Satoki Inoue

Published in: Journal of Anesthesia | Issue 1/2023

Abstract

At present, there is no objective and absolute measure of nociception, although various monitoring techniques have been developed. One such technique is the Analgesia Nociception Index (ANI), which is calculated from heart rate variability that reflects the relative parasympathetic tone. ANI is expressed on a non-unit scale of 0–100 (100 indicates maximal relative parasympathetic tone). Several studies indicated that ANI-guided anesthesia may help reduce intraoperative opioid use. The usefulness of ANI in the intensive care unit (ICU) and during surgery has also been reported. However, some limitations of ANI have also been reported; for example, ANI is affected by emotions and some drugs. In 2022, a high frequency variability index (HFVI), which was renamed from ANI and uses the same algorithm as ANI, was commercialized; therefore, ANI/HFVI are currently in the spotlight. Unlike ANI, HFVI can be displayed along with other biometric information on the Root^® monitor. ANI/HFVI monitoring may affect the prognosis of not only patients in the perioperative period but those in ICU, those who receive home medical care, or outpatients. In this article, we present an updated review on ANI that has been published in the last decade, introduce HFVI, and discuss the outlooks of ANI/HFVI.

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Title: Analgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone
Authors: Keisuke Yoshida
Shinju Obara
Satoki Inoue
Publication date: 22-10-2022
Publisher: Springer Nature Singapore
Keywords: Opioids
Opioids
General Anesthesia
Published in: Journal of Anesthesia / Issue 1/2023
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-022-03126-8

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Analgesia nociception index and high frequency variability index: promising indicators of relative parasympathetic tone

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