Managing analgesia during surgery impacts outcomes, length of stay (LOS) and cost of treatment. It is a major challenge as each patient has a different pain threshold and different physiological responses to the same painful stimulus. Furthermore, studies have shown a wide range of opioid administration practice across physicians, depending on their personal beliefs and experiences. Therefore it is vital to monitor each patient’s personal response and personalise the treatment experiences5.
How can you treat pain if it cannot be measured? Anti-nociceptive agents (intraoperative analgesic medications) are given to patients as part of the general anaesthesia drug regimen, yet physicians have testified that with current methods and technologies, it is extremely difficult to estimate the level of nociception in an anaesthetised patient6. Maintaining the balance between nociception and analgesia (the ‘nociception-antinociception balance’) is critical to avoid postoperative complications7.
Physicians are familiar with the traditional nociception detection methods in anaesthetised patients, which have mainly relied on monitoring blood pressure and heart rate. Yet these have been shown to be suboptimal indicators for nociception monitoring, since vital signs are influenced by a variety of other health conditions8. Various other methods have been used to assess the effectiveness of anti-nociceptive drugs, such as assessment of patient movement and sweating. Nevertheless, these surrogate parameters are largely inaccurate since several anaesthetic components, such as neuromuscular blockers, prevent the patient’s ability to move in response to pain9.
