The NOL® 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
Medasense is developing its pipeline products for clinics and home care, to lead pain prediction, stratification and prevention strategies.
Patients vary in their pain threshold and response to opioids.3 Avoiding excessive use of opioids can improve patient safety and outcomes.2
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.
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.