ANI

The Analgesia Nociception Index (ANI) is an innovative technology that provides a measurement of the parasympathetic tone in order to continuously evaluate the patient’s comfort level. Thanks to the international, independent publications we can provide anesthesiologists a device and a measurement that will individualize and refine their daily practice of anaesthesia. Using ANI, doctors can assess the sympathetic/parasympathetic balance allowing them to TAKE CONTROL OF THE SURGICAL STRESS.

From ECG to ANI:
heart rate variability computation

Heart Rate Variability is a well-known phenomenon that controls the regulation of the cardiovascular system via the Autonomous Nervous System. By analyzing the heart rate variability oscillations, it reflects the activity of the sympathetic and parasympathetic nervous systems.

Developed in order to provide clinicians a monitoring system of analgesia matching the requirements of routine clinical practice, in other words easy to use, easy to interpret, reliable and continuous. During general anesthesia the ANI range relates to adequate analgesia, which means that antinociception is adequate and that the parasympathetic activity is mildly predominant over sympathetic activity.

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ANI MOC-9

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Testimonials

Our technologies are used by top physicians around the world in both OR and ICU settings

Dr. Angel M. Gomez, MD 

The objective measurement of pain is a much sought after goal. Dr. Mathieu Jeanne proposed one such method 10 years ago, and this lead to the development of ANI. Looking at autonomic nervous system responses with an emphasis on the parasympathetic, ANI can guide analgesic delivery by reducing under or overdosing, thereby improving patient outcomes both in the operating theater and ICU.

Dr. Angel M. Gomez, MD 

Clinical Anesthesiologist

Dr. Carlos Chamorro Jambrina

ANI monitor is very useful for monitoring the patient’s autonomic nervous system, especially in those undergoing mechanical ventilation, to titrate analgosedation. This allows a good patient´s synchrony to the ventilator, avoiding the side effects of their overdose, saving drugs and obtaining earlier weanings from mechanical ventilation.

Dr. Carlos Chamorro Jambrina

Phd Intensive Care Unit Hospital Puerta de Hierro Majadahonda, Madrid

Dr. Barvais Luc

The monitoring of the heart rate variability according to a fixed respiratory rate in an anesthetised or sedated patient under controlled positive pressure ventilation is an important noninvasive pharmacodynamic parameter allowing the anaesthetist or the intensivist to reduce the remifentanil TCI or the opioid delivery.  

Dr. Barvais Luc

Head of Cardiovascular Anesthesia Clinics chez Université libre de Bruxelles

Dr. Pablo Ingelmo

Inadequate analgesia is associated with increases in the number of intraoperative and postoperative complications. However, nociception monitoring is currently not part of standard clinical care in anesthesia. ANI could be a useful tool to titrate medication to specific surgical stimulation allowing for a personalized use of analgesics during surgery.

Dr. Pablo Ingelmo

M.D. Pediatric anesthesiologist

Scientific Evidences

Detect noxious stimuli Gruenewald

  • M. et al., (2013). Influence of Nociceptive Stimulation on Analgesia Nociception Index (ANI) During Propofol-Remifentanil Anaesthesia. Br J Anaesth, 110 (6), 1024-30 / LEARN MORE
  • Funcke, S. et al., (2017). Validation of Innovative Techniques for Monitoring Nociception During General Anesthesia: A Clinical Study Using Tetanic and Intracutaneous Electrical Stimulation. Anesthesiology, 127 (2), 272-283 / LEARN MORE
  • Stöckle, PA. et al., (2018). Validation of the PMD100 and Its NOL Index to Detect Nociception at Different Infusion Regimen of Remifentanil in Patients Under General Anesthesia. Minerva Anestesiol, 84 (10), 1160-1168 / LEARN MORE

Predict hemodynamic reactivity

  • Boselli, E., Bouvet, L., Bégou, G., Torkmani, S., Allaouchiche, B. (2015) Prediction of Hemodynamic Reactivity During Total Intravenous Anesthesia for Suspension Laryngoscopy Using Analgesia/Nociception Index (ANI): A Prospective Observational Study. Minerva Anestesiol, 81 (3), 288-97s / LEARN MORE
  • Boselli, E., Logier, R., L Bouvet, L., Allaouchiche, B. (2016) Prediction of Hemodynamic Reactivity Using Dynamic Variations of Analgesia/Nociception Index (∆ANI). J Clin Monit Comput, 30 (6), 977-984 / LEARN MORE
  • Ledowski, T., Averhoff, L., Tiong, WS., Lee, C. (2014). Analgesia Nociception Index (ANI) to Predict Intraoperative Haemodynamic Changes: Results of a Pilot Investigation. Acta Anaesthesiol Scand, 58 (1), 74-9 / LEARN MORE
  • Jeanne, M., Logier, R., De Jonckheere, J., Tavernier, B. (2009). Validation of a Graphic Measurement of Heart Rate Variability to Assess Analgesia/Nociception Balance During General Anesthesia. Conf Proc IEEE Eng Med Biol Soc, 1840-3 / LEARN MORE

Detect the ethiology of the haemodynamic event

  • Logier R., et al. (2011).  Heart Rate Variability Analysis for Arterial Hypertension Etiological Diagnosis During Surgical Procedures Under Tourniquet. Conf Proc IEEE Eng Med Biol Soc, 3776-9
    btention du prix “Entrepreneur de l’année 2014, Born Global” – l’Express / LEARN MORE

Save Analgesics

  • Daccache G., et al. (2017). A Targeted Remifentanil Administration Protocol Based on the Analgesia Nociception Index During Vascular Surgery. Anaesth Crit Care Pain Med, 36 (4), 229-232
    ogier R., et al. (2011).  Heart Rate Variability Analysis for Arterial Hypertension Etiological Diagnosis During Surgical Procedures Under Tourniquet. Conf Proc IEEE Eng Med Biol Soc, 3776-9
    btention du prix “Entrepreneur de l’année 2014, Born Global” – l’Express / LEARN MORE
  • Dundar, N., Kus, A., Gurkan, Y., Toker, K., Solak, M. (2017). Analgesia nociception index (ani) monitoring in patients with thoracic paravertebral block: a randomized controlled study. J Clin Monit Comput. 32 (3), 481-486 / LEARN MORE

ANI can be used in Diabetics and beta-blocker treated patients with similar results

  • Daccache G., et al. (2017). A Targeted Remifentanil Administration Protocol Based on the Analgesia Nociception Index During Vascular Surgery. Anaesth Crit Care Pain Med, 36 (4), 229-232 / LEARN MORE

Ani can be used to titrate analgesics in children

  • Content
    Gruenewald, M., Ilies, C., Herz, J., Schoenherr, T., Fudickar, A., Höcker, J., Bein, B. (2013). Influence of nociceptive stimulation on analgesia nociception index (ANI) during propofol-remifentanil anaesthesia. Br J Anaesth. 110 (6),1024-30 / LEARN MORE

ANI can be used to monitor the effects of dexmedetomidine

  • Gazi, M., et al. (2018). Evaluation of the Effects of Dexmedetomidine and Remifentanil on Pain With the Analgesia Nociception Index in the Perioperative Period in Hysteroscopies Under General Anesthesia. A Randomized Prospective Study. Saudi Med J, 39 (10), 1017-1022 / LEARN MORE

Predict Post OP Pain

  • Boselli, E., et al. (2014). Prediction of Immediate Postoperative Pain Using the Analgesia/Nociception Index: A Prospective Observational Study. Br J Anaesth, 112 (4), 715-21 / LEARN MORE

Improve Patient outcomes, Reduce lenght of stay

  • Ramos-Luengo, A., Gardeta Pallarés, A., Asensio Merino, F.  (2020). Usefulness of ANI (Analgesia Nociception Index) Monitoring for Outpatient Saphenectomy Surgery Outcomes: An Observational Study. J Clin Monit Comput (Online ahead of print) / LEARN MORE

Reduce post op NRS , PONV and Shivering scores

  • Upton, HD, Ludbrook, GL., Wing, A., Sleigh, JW. (2017). Intraoperative “Analgesia Nociception Index”-Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy: A Randomized Clinical Trial. Anesth Analg, 125 (1), 81-90 / LEARN MORE
  • Abdullayev, R., Uludag, o., Celik, B. (2019). Analgesia Nociception Index: Assessment of Acute Postoperative Pain. Rev Bras Anestesiol. 69 (4), 396-402 / LEARN MORE

Videos

HRV, ANS power and inflammation

Prove of concept Analgesia Nociception Index

ANI (Analgesia Nociception Index) technology explained