The NOL® Index
NOL (Nociception Level) is the index and technology developed by Medasense to objectively quantify a patient’s physiological pain response (nociception), enabling surgical teams to provide personalized pain treatment for anaesthetized, non-communicating patients.
NOL-guided analgesia reduces the risk of excessive use or underuse of opioids and associated complications.1
Enhance intraoperative pain control to meet the patient’s analgesic needs and improve postoperative pain scores.
How We Complete the Missing Piece in Anaesthesia
The Physiological Principles Behind NOL
Activation of the sympathetic nervous system, as a result of multiple stimuli and inputs, leads to a constellation of nociception-related physiological responses, with complex inter-associations and different response profiles. Recognizing the complex nature of this process, the Nociception Level (NOL) index was developed as a multiparameter composite of autonomic signals.
Shown to reduce reported pain scores in the PACU4
Reducing hypotension, improving haemodynamic stability and sparing opioids1
Potential cost savings within one year – and better use of healthcare resources5
How NOL helps personalize opioid administration, with Dr. Hugo Vereecke, Belgium
Lecture series: Prof. Stefan Schraag on NOL Monitoring in Thoracic Anaesthesia
Lecture series: Prof. Dan Longrois on NOL Monitoring and Titration of Anaesthetic Drugs
- Meijer, F., Martini, C., Broens, S., Boon, M., Niesters, M., Aarts, L., Olofsen, E., van Velzen, M., Dahan, A. (2019). Nociception-guided versus Standard Care during Remifentanil–Propofol Anesthesia: A Randomized Controlled Trial. Anesthesiology, 130(5), 745-755. doi:10.1097/ALN.0000000000002634
- Edry, R., Recea, V., Didust, Y. & Sessler, D. I. (2016). Intraoperative validation of the NOL Index, a non-invasive nociception monitor. Anesthesiology, 125, 193-203.
- Martini, C. H., Boon, M., Broens, S. J. L., Hekkelman, E. F., Oudhoff, L. A., Buddeke, A. W., Dahan, A. (2015). Ability of the Nociception Level (NOL), a multiparameter composite of autonomic signals, to detect noxious stimuli during propofol-remifentanil anesthesia. Anesthesiology, 123, 524-534.
- Meijer, F., Honing, M., Roor, T., Toet, S., Calis, P., Olofsen, E., Martini, C., van Velzen, M., Aarts, L., Niesters, M., Boon, M., Dahan, A. (2020). Reduced postoperative pain using Nociception Level-guided fentanyl dosing during sevoflurane anaesthesia: a randomised controlled trial. British Journal of Anaesthesia, 125(6), 1070-1078.
- Saunders R., Weissbrod R. (2020). Cost benefit of personalizing intraoperative pain management. Presented at ISPOR Virtual Conference, May 2020.