NOL Technology

Control pain. Avoid overdose. Eliminate doubt.

The NOL – Nociception Level Index®

NOL (Nociception Level) is the technology and index developed by Medasense to objectively quantify a patient’s physiological pain response (nociception), enabling clinical teams to provide personalized pain treatment.

Medasense’s flagship product, PMD-200™ applies this technology in critical care settings to visualize pain response and personalize treatment. Recent evidence shows that NOL-guided surgery results in 33% less pain.1 Other studies have shown that NOL-guided analgesia reduces the risk of excessive use or underuse of opioids and associated complications.2

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Medasense is developing its pipeline products for clinics and home care, to lead pain prediction, stratification and prevention strategies.

Control Pain

Objectively measure pain and tailor analgesia dosing to each patient’s needs.

Avoid Overdose

Patients vary in their pain threshold and response to opioids.3 Avoiding excessive use of opioids can improve patient safety and outcomes.2

Eliminate Doubt

NOL monitoring enables confident assessment of the adequacy of pain treatment.

How It Works

The Physiological Principles Behind NOL

NOL is based on a proprietary, patented artificial intelligence technology that quantifies the individual physiological response to pain in real-time, continuously and noninvasively.

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 PACU1
Reducing hypotension, improving haemodynamic stability and sparing opioids2
Potential cost savings within one year – and better use of healthcare resources4
Safe, noninvasive, continuous and simple to use


Video Highlights

Medasense - Our Vision: Guiding critical care clinicians for optimal pain care

Meeting the challenge of intraoperative pain monitoring

Leading clinicians on the importance of monitoring the patient’s pain response level

1. 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.
2. 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
3. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K.; Cahalan, Michael K.; Stock, M. Christine; Ortega, Rafael; Sharar, Sam R.; Holt, Natalie F. 2017. Clinical Anesthesia, 8th Ed. Lippincott Williams & Wilkins (LWW).
4. Saunders R., Weissbrod R. (2020). Cost benefit of personalizing intraoperative pain management. Presented at ISPOR Virtual Conference, May 2020.