Effect of combined intraoperative use of the Nociception Level (NOL) and bispectral (BIS) indexes on desflurane administration.

Background: Currently, nociception monitors are not part of standard anaesthesia care. We investigated whether combined intraoperative nociception (NOL index) and anaesthesia (BIS index) monitoring during general anaesthesia would reduce anaesthetics consumption and enhance intraoperative safety and postoperative recovery when compared to standard of care monitoring (SOC).

Methods: In this randomised study, we included 60 patients undergoing colonic surgery under desflurane/remifentanil anaesthesia and epidural analgesia.

Host perspective on academic supervision, health care provision and institutional partnership during short-term electives in global health.

Context: Studies about the impact of global health electives on host institutions are scarce and often made from the perspective of institutions that send students. The present research examined the impact of short-term electives in global health (STEGHs) from the under-represented perspective of host institutions in Benin.

Methods: The authors conducted 30 semi-structured interviews from a convenience sample of Beninese health care professionals who had hosted Canadian medical students.

Impact of intravenous phenylephrine bolus administration on the nociceptive level index (NOL).

Recently, the nociceptive level index (NOL) was shown to more specifically and sensitively detect noxious stimuli during anesthesia, in comparison to previous methods that relied on such parameters as heart rate (HR) and mean blood pressure (MAP). An ongoing study (NCT#03410485) evaluates the intraoperative combination of both NOL and bispectral (BIS) indices to improve quality of recovery after colorectal surgery. Our ethical committee (REB approval #CER15083) initially agreed on an interim analysis of the data from the first 30 patients.

Correlation between incremental remifentanil doses and the Nociception Level (NOL) index response after intraoperative noxious stimuli.

Background: The Pain Monitoring Device (PMD) monitor (Medasense Biometrics Ltd., Ramat Gan, Israel) uses the Nociception Level (NOL) index, a multiple parameter-derived index that has recently shown a good sensitivity and specificity to detect noxious stimuli. The aim of this study was to assess the latest version of the device (PMD200) on variations of the NOL response after standardized tetanic stimuli to study the correlation between remifentanil doses and NOL.