tive system for measuring and monitoring pain could soon be a reality.
Anis Dizdarevic, MD, the director of regional anesthesia and acute pain
medicine at Montefiore Medical Center in the Bronx, N.Y., says pain
monitors employ the analgesia nociception index (ANI) and nocicep-
tion level (NoL) index. These measurements are based on capturing
changes in different parameters such as heart rate, respiratory rate,
sympathetic tone and parasympathetic tone, and providing a number
or "index" that represents the patient's level of nociception — the sen-
sory nervous system's response to harmful or potentially harmful stim-
uli.
Essentially, pain monitors take into account the physiological fac-
tors that are affecting patients under anesthesia, put them into an
algorithm and provide an accurate reading of the level of pain
they're likely to be in — and the corresponding level of analgesia
they're likely to need. Compare that to the current level of pain
"monitoring," which involves providers looking for variations in a
single parameter.
"They may see an elevated blood pressure, while all other readings
are stable, and treat that blood pressure thinking the patient is in pain,"
says Jacob Hutchins, MD, MHA, executive medical director of M Health
Fairview ASC in Minneapolis. "But if the patient's baseline blood pres-
sure was [the only parameter that was] elevated, it's unlikely they're in
discomfort."
He believes pain monitors can help to eliminate those misconcep-
tions by incorporating patient data into a single number, which
providers can use to guide their pain management interventions.
Dr. Hutchins, who points out biotech and pharma companies are
focusing on developing effective ways to manage pain, sees the opioid
crisis as a catalyst for bringing pain-monitoring devices to market as
quickly as possible.
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