Evaluation of analgesic methods in elective lumbar vertebral surgery by early analgesia nociception index (ANI) monitoring in the postoperative period

Aim: We aimed to compare the efficacy of the lumbar erector plan block and intravenous analgesia methods that we apply for analgesia in patients who will undergo lumbar spine surgery and to evaluate whether there is a correlation between NRS and ANI monitoring in the early postoperative period. Method: In our retrospective, observationally planned study; ASA I-II patients, aged 18-65 years, who will undergo lumbar vertebral surgery and who are informed preoperatively and approved according to the study criteria, were included. 54 patients included in the study were grouped as Group 1 (n = 28, paracetamol + tramadol) and Group 2 (n = 26, erector spine plan block) according to the postoperative analgesia method, which was monitored with ANI, and their perioperative records were examined. ANI values, NRS, heart rate, noninvasive systolic and diastolic blood pressures, nausea and vomiting were recorded in patients who were taken to the postoperative recovery unit. At the end of the study period, at 60 minutes, patients with ANI values of 50 or less were administered rescue analgesia. The data were analyzed statistically using IBM SPSS Statistics 20 program. Results: There were 54 patients in our study, 28 in Group 1 and 26 in Group 2. While the average age of all patients in our study was 59.4 ± 9 years, the average age of patients in Group 1 was 59.0 ± 9.8 years and 59.8 ± 8.3 years for Group 2. 37% (n = 20) of the patients were male and 63% (n = 34) were female. 71.4% (n = 20) of the patients in Group 1 were female, 28.6% (n = 8) of the male, 53.8% of the patients in Group 2 (n = 14) were female,% 46.2 (n = 12) were male. In terms of ANI and NRS values, there was no difference between the groups and no correlation was found between them. When Group 1 and Group 2 were compared in terms of heart rate and systolic blood pressure values, no significant results were obtained. At the end of the 60th minute, there were 8 patients in Group 1 and 6 patients in Group 2 whose ANI value was 50 and below. Rescue analgesia was applied to these patients. Conclusion: Considering the results of our study, which did not show any relationship between ANI and NRS values in the early postoperative period in patients undergoing lumbar vertebral surgery, we believe that more studies are needed regarding the use of ANI monitoring in the early postoperative period. Key words: Postoperative, Lumbar spine surgery, Erector spina plan block, Analgesia nociception index