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.

Clinical studies and economic analysis have demonstrated:

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 the U.S., Europe, Canada, South Africa, UAE, Israel, and Latin America

What experts are saying

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


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.