Avez-Couturier Justine, De Jonckheere Julien, Jeanne Mathieu, Vallée Louis, Cuisset Jean-Marie, Logier Régis
*Department of Pediatric Neurology, University Hospital of Lille †CIC-IT 1403, University Hospital of Lille §Department of Anesthesiology and Intensive Care, University Hospital of Lille ‡UPRES-EA4489, Faculty of Medicine, Lille I & Lille II Universities ∥UPRES-EA2694, Faculty of Medicine, Lille II University, Lille, France.
Clin J Pain. 2016 Dec;32(12):1100-1104. doi: 10.1097/AJP.0000000000000360.
The Analgesia Nociception Index (ANI), based on heart rate (HR) variability analysis, is known to decrease after a painful stimulus during surgery under general anesthesia in adults. It is measured continuously and noninvasively. We studied ANI response to procedural pain in a pediatric population and ANI measurement's feasibility in this context, across age.
A prospective, noninterventional pilot study was performed. All children (between 6 mo and under 18 y) undergoing muscle biopsy conducted under analgesia and light sedation were included. Medical staff was blind to the ANI monitor. HR and ANI were recorded and analyzed during 2 periods: T1 before incision and T2 after incision. Pain was assessed by the FLACC scale at T2. We observed ANI and HR variations after incision. ANI, HR, and FLACC were compared between children younger or older than 6 years. Enrollment or technical issues were reported.
A total of 26 children were included (median age, 6 y; ranging from 6 mo to 16 y; 16 male). ANI decreased from T1 to T2. HR, ANI, or FLACC values were not different in children younger or older than 6 years. No parents or children refused to take part in the study. No technical issues was reported.
In this pilot study, ANI measurement seems relevant in pediatric procedural pain, across age. Further studies are needed to confirm these results.
基于心率（HR）变异性分析的镇痛伤害感受指数（ANI），已知在成人全身麻醉手术期间受到疼痛刺激后会降低。它是连续且无创测量的。我们研究了儿科人群中ANI对程序性疼痛的反应以及在此背景下不同年龄段ANI测量的可行性。
进行了一项前瞻性、非干预性的试点研究。纳入所有在镇痛和轻度镇静下接受肌肉活检的儿童（6个月至18岁以下）。医护人员对ANI监测仪不知情。在两个时间段记录并分析心率和ANI：T1为切开前，T2为切开后。在T2时通过FLACC量表评估疼痛。我们观察了切开后ANI和心率的变化。比较了6岁以下和6岁以上儿童的ANI、心率和FLACC。报告了入组或技术问题。
共纳入26名儿童（中位年龄6岁；范围从6个月至16岁；16名男性）。ANI从T1降至T2。6岁以下和6岁以上儿童的心率、ANI或FLACC值没有差异。没有家长或儿童拒绝参与研究。未报告技术问题。
在这项试点研究中，ANI测量在儿科程序性疼痛中似乎与年龄无关。需要进一步研究来证实这些结果。
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