A new study has shown that effective opioid-sparing anaesthesia with dexmedetomidine can be guided with NOL pain monitoring technology. The study showed that the NOL monitor is able to detect the effect of dexmedetomidine on the patient’s pain response and enable administration of less intraoperative opioids.
Patients undergoing anaesthesia for surgical procedures are traditionally treated with opioids (e.g., remifentanil) to manage intraoperative pain. But clinicians are progressively seeking to reduce opioid use by introducing multimodal analgesia, a technique that involves a combination of medications that often includes a central alpha agonist, such as dexmedetomidine. This approach may offer pain relief, offset potentially adverse effects of individual drugs in larger doses and enable a reduction of opioid use during surgery.1 With this strategy, however, clinicians are not always able to predict whether the impact of the drug combination will be effective or excessive.
The study, just published in the European Journal of Anaesthesiology,2 has shown that NOL can provide an objective reflection of dexmedetomidine’s effects, helping the clinician in the decision-making process when applying multimodal pain relief, with the potential for significant opioid sparing during surgery.
- Kehlet H, Dahl JB. The value of ‘multimodal’ or ‘balanced analgesia’ in postoperative pain treatment. Anesth Analg 1993; 77: 1048-1056.
- Coeckelenbergh S, Doria S, Patricio D, Perrin L, Engelman E, Rodriguez A, Di Marco L, Van Obbergh L, Estebe JP, Barvais L, Kapessidou P. Effect of dexmedetomidine on Nociception Level Index-guided remifentanil antinociception: A randomised controlled trial. Eur J Anaesthesiol. 2021 May 1;38(5):524-533. doi: 10.1097/EJA.0000000000001402. PMID: 33259449