Estimative pain measurement during perioperative period: a review of current available devices

Abstract

Pain is a complex subjective organic function which is influenced by sensorial, emotional, cognitive and behavioral elements. Despite the wide offer of pain measurement devices in the perioperative period, none of them is completely validated for their transverse use in the anesthetic practice. The aim of this review is to present the existing devices for objective pain evaluation during the perioperative period along with the scientific evidence supporting each of them. Articles from the PubMed/MEDLINE literature search engine were reviewed. As result, 37 articles were selected due to its relevance, from which 13 pain assessment devices were described, regarding its clinical relevance as well as the amount of scientific evidence found. Among them are ANI, NOL, pupillometry, qNOX, and others. The nociceptive measurement performed by most of these is based mainly on the evaluation of the autonomic nervous system activity and variations of the electroencephalographic signal. However, it is not possible to recommend any particular device. This review aims to offer a broad overview of the available options in order to estimate the role that each of them could play in clinical anesthesiology practice.