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Special Edition: Hot Technology - April 2020 - Subscribe to Outpatient Surgery Magazine

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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. 2 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 2 0

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