Intraoperative opioid dosing based on the NOL index significantly reduces post-operative pain

The odds of experiencing severe pain in the post-anesthesia care unit (PACU) is six times lower with Nociception Level (NOL) guided intraoperative analgesia compared to standard of care monitoring.

A new study, which pooled data from two randomized clinical trials (Meijer et al 2020, Fuica et al 2022), found that intraoperative opioid dosing based on the NOL index reduced the proportion of patients reporting severe pain by 70% and improved PACU pain scores by a median of 1.5 NRS points at 90 minutes post surgery. Additionally, NOL guidance was the only significant factor explaining the difference in the number of patients experiencing severe pain (OR 5.98, p=0.02).

“The study shows that how NOL monitoring can help minimize the prevalence of severe pain after surgery and all of its negative repercussions,” says Prof. Albert Dahan, who led the study. “This represents an important benefit of nociception monitoring to patients and clinicians alike”.

Medasense's NOL technology uses machine learning algorithms to continuously monitor patients during surgery, providing real-time information on nociception levels, personalizing dosing of analgesics to the patients’ actual requirements. Earlier studies have shown that the NOL index outperforms other indexes for monitoring of pain response to surgical stimuli and that NOL-guided analgesia resulted in reduced intraoperative opioid consumption, leading to fewer intraoperative hypotensive events.