Research Information System
Anestezi Dergisi, vol.32, no.3, pp.167-173, 2024 (Scopus)
Objective: This study evaluated the analgesia nociception index (ANI) for pain assessment in conscious, sedated, and mechanically ventilated patients in the cardiovascular intensive care unit (ICU) after elective coronary artery bypass graft (CABG) surgeries. It also explored the influence of inotropic/vasoconstrictor agents on ANI. Methods: Conducted from January 2019 to January 2020, the study enrolled 135 participants who underwent elective isolated CABG surgeries. Participants were categorized into three groups: Group S0 received no additional cardiac support, Group S1 received inotropic support with dopamine, and Group S2 received combined inotropic and vasopressor support. Analgesia nociception index electrodes were placed at V1 and V5 leads for ANI assessment at key time points: before extubation (Eb), after extubation (Ea), before thoracic drain removal (Rb), and after thoracic drain removal (Ra). Results: Gender distribution showed no significant differences. Intubation duration was significantly longer in Group S2 compared to Groups S0 and S1. Hemodynamic parameters varied significantly. Mean arterial pressure (MAP) and heart rate (HR) increased significantly from Eb to Ea and decreased from Rb to Ra. Specifically, MAP increased from 82.4 ± 8.1 mmHg to 89.6 ± 9.2 mmHg (p<0.05) and HR increased from 72.5 ± 7.4 bpm to 78.3 ± 8.6 bpm (p<0.05) between Eb and Ea. Conversely, MAP decreased from 90.2 ± 8.4 mmHg to 85.1 ± 8.3 mmHg (p<0.05) and HR decreased from 80.5 ± 7.5 bpm to 74.2 ± 7.8 bpm (p<0.05) between Rb and Ra. ANI values varied across groups and time points, with Group S2 showing higher ANI values post-extubation (Ea) and post-thoracic drain removal (Ra). Conclusion: ANI is a feasible tool for continuous pain assessment in the cardiovascular ICU post-cardiac surgery. The dynamic hemodynamic responses and distinct ANI patterns highlight ANI’s potential in tailoring postoperative pain management strategies.