University of Western Australia, Perth, Australia; Royal Perth Hospital, Perth, Australia.
Christian-Albrechts University, Kiel, Germany.
Br J Anaesth. 2020 Feb;124(2):222-226. doi: 10.1016/j.bja.2019.09.041. Epub 2019 Nov 21.
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.
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.
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).
QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU.
ACTRN12618001662257.
QNox 评分（Quantium Medical S.L.，由 Fresenius Kabi 分销）最近被引入作为一种量化术中镇痛的工具。基于脑电图数据的分析，QNox 与其他依赖于几乎完全评估交感神经活动的疼痛监测方法明显不同。然而，目前尚无关于 QNox 在临床环境中使用的验证数据。我们研究了手术结束时预唤醒 QNox 数据对 PACU 中急性术后疼痛的预测价值。
本研究纳入了 150 名计划在七氟醚-阿片类药物全身麻醉下接受非紧急手术的患者。在手术结束但患者未苏醒前，对 QNox 进行了 5 分钟的细微测量。在进入恢复室后，每 5 分钟测量一次疼痛评分（数字评分量表 [NRS]，0-10），共 15 分钟。
分析了 144 名患者的数据。苏醒前的 QNox 与 PACU 中的急性术后疼痛无相关性（ρ=0.057）。此外，该评分对急性术后疼痛的预测也没有价值（受试者工作特征曲线下面积，0.501；95%置信区间，0.406-0.597）。
苏醒前手术结束时的 QNox 与 PACU 中的急性疼痛无关联，也无法预测。
ACTRN12618001662257。
