PMD-200TM

Monitoring physiological pain response to improve pain management in critical patients

Accurate, continuous and noninvasive

Leveraging NOL technology, the PMD-200™ monitoring device quantifies the patient’s physiological response to pain (nociception).

The PMD-200 is designed for the operating room and critical care settings, where patients under general anaesthesia are unable to communicate their pain. The system enables clinicians to assess nociception and objectively titrate analgesics to meet the patient’s specific needs with optimized timing and dosage.

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  • Smoother procedures
  • Improved patient safety
  • Better outcomes
Clinical studies and economic analysis have demonstrated:
33% less postoperative pain 1
80% fewer hypotensive events 2
ROI within the first year 3

How We Complete the Missing Piece in Anaesthesia

While hypnosis and muscle relaxation can be continuously and specifically monitored during anaesthesia, analgesia has generally been assessed indirectly through changes in heart rate (HR), blood pressure (BP) and other parameters. However, studies have shown that HR and BP are poor surrogates for assessing nociception and adequacy of analgesia.4,5 Therefore, a more reliable and specific nociception monitoring solution is necessary.

NOL technology monitors a constellation of nociception-related physiological responses to reflect a patient’s analgesic needs.

NOL Index Monitoring - The Missing Piece in Anesthesia Monitoring

Stand-alone or connected with Philips and Mindray patient monitors

User-friendly interface
Available in 12 languages

Commercially available in Europe, Canada, Australia, Israel, Turkey, UAE, Latin America

What experts are saying

“Thanks to the NOL technology, I can extubate the patient and wake them up in a consistent and predictable way”
Dr. Hugo VereeckeConsultant Anesthetist, AZ Sint-Jan Brugge-Oostende AV, Belgium
Dr. Hugo Vereecke
“In the past, we were thinking about a patient as an average and focused on treating the average which is wrong because we can’t. What better to have a tool in hand where we can individualize the pain management of these patients”
Prof. Stefan SchraagSenior Consultant Cardiothoracic Anaesthetist, Golden Jubilee Foundation, Scotland
Prof. Stefan Schraag
“The most important part of NOL monitoring is personalizing and individualizing dosing because the differences between patients is so high that without it you cannot reliably detect inter-patient variability”
Prof. Dan LongroisProfessor of Anaesthesia and Intensive Care Bichat–Claude Bernard Hospital, France
Prof. Dan Longrois
"NOL can make over- and under-analgesia less likely and opioid dosing safer, especially in high-risk and opioid-tolerant patients."
Frank J. Overdyk, MSEE, MDAnesthesiologist, Medical Director, Charleston, SC, USA
Frank J. Overdyk, MSEE, MD
"Getting the right dose of anti-nociceptive medications matters. Too little, and patients wake up in pain. Too much, and patients are at risk of drug-related complications."
Prof. Daniel SesslerHead of Department of Outcomes Research, Cleveland Clinic, Ohio, USA. A member of Medasense’s advisory board
Prof. Daniel Sessler
"Our study confirmed that the NOL gives a better assessment of the patient’s nociceptive state than the parameters we currently use in the operating theatre."
Dr. Ruth EdryHead of Acute Pain Service, Anesthesiology, Rambam Medical Center, Haifa, Israel
Dr. Ruth Edry
"I feel confident using NOL and BIS monitoring intraoperatively to keep depth of anaesthesia and analgesia within clinical targets at all times and ensuring effective analgesia."
Prof. Anil HormisConsultant in Anaesthesia, Critical Care and Pre-hospital Emergency Medicine, Rotherham NHS Foundation Trust, UK
Prof. Anil Hormis
"It is clear that current pain assessment approaches in the operating room are limited. The NOL index provides anesthesiologists with a decision support tool to objectively assess and optimize the treatment of a patient’s nociception."
Prof. Albert Dahan, MD, PhDDepartment of Anaesthesiology, Leiden University Medical Center, The Netherlands
Prof. Albert Dahan, MD, PhD
"I truly believe in the NOL technology. I am convinced it will improve the quality of our anesthesia and impact patient recovery."
Prof. Philippe RichebéProfessor and Anesthesiologist, Maisonneuve-Rosemont Hospital, University of Montreal, Quebec, Canada
Prof. Philippe Richebé
"NOL enables direct, rapid monitoring, and with regional anaesthesia indicates when we should check whether something is not in order, such as patient discomfort of some kind."
Dr. med. Doreen WiedemannDepartment of Anesthesiology and Intensive Care, Otto-von-Guericke-Universität Magdeburg, Germany
Dr. med. Doreen Wiedemann
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Video Highlights

How NOL monitoring helps guide TIVA TCI anaesthesia | Dr. Hugo Vereecke

NOL guided analgesia in daily practice with Prof. Philippe Richebé

TV News: Patients in Portugal are getting customized anaesthesia care with NOL

REFERENCES:

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 [In Press]
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. Saunders R., Weissbrod R. (2020). Cost benefit of personalizing intraoperative pain management. Presented at ISPOR Virtual Conference, May 2020
4. 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.
5. 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.