Predicting acute postoperative pain by the Qnox score at the end of surgery: a prospective observational study

Thomas Ledowski, Isabel Schmitz-Rode

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The QNox score (Quantium Medical S.L., distributed by Fresenius Kabi) has recently been introduced as a tool to quantify intraoperative analgesia. Being based on the analysis of electroencephalographic data, QNox is distinctly different to other methods of nociception monitoring that rely almost entirely on the assessment of sympathetic activity. However, there are currently no published data to validate use of QNox in a clinical setting. We investigated the value of pre-arousal QNox data at the end of surgery for prediction of acute postoperative pain in the PACU.

METHODS: A total of 150 patients scheduled for non-emergency surgery under sevoflurane-opioid general anaesthesia were included in the study. At the end of surgery but before patient arousal, QNox was measured minutely for 5 min. After admission to the recovery room, pain scores (numeric rating scale [NRS], 0-10) were obtained 5 minutely for 15 min.

RESULTS: Data from 144 patients were analysed. QNox before arousal showed no correlation (ρ=0.057) with acute postoperative pain in the PACU. Furthermore, the score was found to have no value for the prediction of acute postoperative pain (area under the receiver operating curve, 0.501; 95% confidence interval, 0.406-0.597).

CONCLUSION: QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU.

CLINICAL TRIAL REGISTRATION: ACTRN12618001662257.

Original languageEnglish
Pages (from-to)222-226
JournalBritish Journal of Anaesthesia
Volume124
Issue number2
DOIs
Publication statusPublished - Feb 2020

Fingerprint

Acute Pain
Postoperative Pain
Arousal
Observational Studies
Prospective Studies
Recovery Room
Nociception
Analgesia
General Anesthesia
Opioid Analgesics
Clinical Trials
Confidence Intervals
Pain

Cite this

@article{071e4c99d0b24018a0b1a09d87865807,
title = "Predicting acute postoperative pain by the Qnox score at the end of surgery: a prospective observational study",
abstract = "BACKGROUND: The QNox score (Quantium Medical S.L., distributed by Fresenius Kabi) has recently been introduced as a tool to quantify intraoperative analgesia. Being based on the analysis of electroencephalographic data, QNox is distinctly different to other methods of nociception monitoring that rely almost entirely on the assessment of sympathetic activity. However, there are currently no published data to validate use of QNox in a clinical setting. We investigated the value of pre-arousal QNox data at the end of surgery for prediction of acute postoperative pain in the PACU.METHODS: A total of 150 patients scheduled for non-emergency surgery under sevoflurane-opioid general anaesthesia were included in the study. At the end of surgery but before patient arousal, QNox was measured minutely for 5 min. After admission to the recovery room, pain scores (numeric rating scale [NRS], 0-10) were obtained 5 minutely for 15 min.RESULTS: Data from 144 patients were analysed. QNox before arousal showed no correlation (ρ=0.057) with acute postoperative pain in the PACU. Furthermore, the score was found to have no value for the prediction of acute postoperative pain (area under the receiver operating curve, 0.501; 95{\%} confidence interval, 0.406-0.597).CONCLUSION: QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU.CLINICAL TRIAL REGISTRATION: ACTRN12618001662257.",
author = "Thomas Ledowski and Isabel Schmitz-Rode",
year = "2020",
month = "2",
doi = "10.1016/j.bja.2019.09.041",
language = "English",
volume = "124",
pages = "222--226",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "2",

}

Predicting acute postoperative pain by the Qnox score at the end of surgery : a prospective observational study. / Ledowski, Thomas; Schmitz-Rode, Isabel.

In: British Journal of Anaesthesia, Vol. 124, No. 2, 02.2020, p. 222-226.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predicting acute postoperative pain by the Qnox score at the end of surgery

T2 - a prospective observational study

AU - Ledowski, Thomas

AU - Schmitz-Rode, Isabel

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND: The QNox score (Quantium Medical S.L., distributed by Fresenius Kabi) has recently been introduced as a tool to quantify intraoperative analgesia. Being based on the analysis of electroencephalographic data, QNox is distinctly different to other methods of nociception monitoring that rely almost entirely on the assessment of sympathetic activity. However, there are currently no published data to validate use of QNox in a clinical setting. We investigated the value of pre-arousal QNox data at the end of surgery for prediction of acute postoperative pain in the PACU.METHODS: A total of 150 patients scheduled for non-emergency surgery under sevoflurane-opioid general anaesthesia were included in the study. At the end of surgery but before patient arousal, QNox was measured minutely for 5 min. After admission to the recovery room, pain scores (numeric rating scale [NRS], 0-10) were obtained 5 minutely for 15 min.RESULTS: Data from 144 patients were analysed. QNox before arousal showed no correlation (ρ=0.057) with acute postoperative pain in the PACU. Furthermore, the score was found to have no value for the prediction of acute postoperative pain (area under the receiver operating curve, 0.501; 95% confidence interval, 0.406-0.597).CONCLUSION: QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU.CLINICAL TRIAL REGISTRATION: ACTRN12618001662257.

AB - BACKGROUND: The QNox score (Quantium Medical S.L., distributed by Fresenius Kabi) has recently been introduced as a tool to quantify intraoperative analgesia. Being based on the analysis of electroencephalographic data, QNox is distinctly different to other methods of nociception monitoring that rely almost entirely on the assessment of sympathetic activity. However, there are currently no published data to validate use of QNox in a clinical setting. We investigated the value of pre-arousal QNox data at the end of surgery for prediction of acute postoperative pain in the PACU.METHODS: A total of 150 patients scheduled for non-emergency surgery under sevoflurane-opioid general anaesthesia were included in the study. At the end of surgery but before patient arousal, QNox was measured minutely for 5 min. After admission to the recovery room, pain scores (numeric rating scale [NRS], 0-10) were obtained 5 minutely for 15 min.RESULTS: Data from 144 patients were analysed. QNox before arousal showed no correlation (ρ=0.057) with acute postoperative pain in the PACU. Furthermore, the score was found to have no value for the prediction of acute postoperative pain (area under the receiver operating curve, 0.501; 95% confidence interval, 0.406-0.597).CONCLUSION: QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU.CLINICAL TRIAL REGISTRATION: ACTRN12618001662257.

UR - http://www.scopus.com/inward/record.url?scp=85077737018&&partnerID=8YFLogxK

U2 - 10.1016/j.bja.2019.09.041

DO - 10.1016/j.bja.2019.09.041

M3 - Article

VL - 124

SP - 222

EP - 226

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 2

ER -