Identification of the intraoperative antinociceptive effect of intravenous fentanyl using the Nociception Level (NOL) index versus clinical parameters in patients undergoing gynecological laparoscopic surgery: A secondary analysis of the NOLGYN study.

Background: While we typically assess nociception balance during general anesthesia through clinical parameters such as heart rate (HR) and mean arterial pressure (MAP) variation, these parameters are not specific to nociception.

Objective: We hypothesized that using the Nociception Level (NOL) index to assess the analgesic effect of a fentanyl bolus would be superior to standard clinical parameters.

Design: Ancillary study of the NOLGYN study, a randomized controlled trial comparing intraoperative NOL-guided administration of fentanyl (NOL group) versus standardized care (SC group).

A simulation model to analyse automation scenarios in decontamination centers.

Decontamination centres provide sterilisation services (sort, disinfect, package, and sterilise) for reusable surgical instruments that have a vital impact on patient safety. The market trend is to increase the level of automation in the decontamination process, to increase productivity, and reduce the risk of human error and musculoskeletal injuries. The goal of this research is to study the use of automated guided vehicles (AGVs) in sterilisation departments, to improve safety and efficiency.