Analgesia Optimization

Managing nociception during surgery is a major challenge, impacting patient outcomes, length of stay and cost of treatment.

Excessive use of opioids may result in intraoperative hypotension, respiratory depression, PONV etc.,1,2,3 and underuse of analgesics may promote acute or chronic post-operative pain, delayed recovery and the costs associated with these complications.4,5,6

Our Solution to Monitor Pain

The PMD-200TM nociception monitor, developed by Medasense Ltd., helps you monitor your anaesthetized patients' physiological pain response (nociception) to noxious stimuli and tailor analgesic medications to each patient’s specific sensitivity and needs. The integrated nociception level index (NOL®)  provides superior indication of the presence and severity of pain response vs. individual parameters (such as changes in heart rate and blood pressure) to reduce complications and  improve patient outcomes.7,8

How does Nociception Monitoring work?

1. ACQUIRE     →     2. ANALYZE     →     3. QUANTIFY     →     4. OPTIMAL PAIN CARE

Potential to Reduce Post-Operative Complications

By optimizing analgesic administration in critical care, NOL®-guided analgesia might enhance the patient experience as it reduces the risk of excessive use or underuse of opioids and associated complications.9



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  • 1. Desborough JP, (2000), The stress response to trauma and surgery, Br J Anaesth. 85:109–117.

  • 2. Kehlet H et al., (2006), Persistent postsurgical pain: risk factors and prevention, Lancet 367(9522):1618-25

  • 3. Kehlet H et al., (1997), Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78:606–617

  • 4. Lee LA et al., (2015), Postoperative Opioid-induced Respiratory Depression: A Closed Claims Analysis. Anesthesiology 122:659-665

  • 5. Smith HS et al., (2014), Opioid induced nausea and vomiting. Eur J Pharmacol. 722:67-78

  • 6. Fletcher D et al., (2014), Opioid-induced hyperalgesia in patients after surgery: A systematic review and a meta analysis. Br J Anaesth 112:991-1004

  • 7. Edry R et al., (2016),  Preliminary intraoperative validation of the NOL (Nociception Level) Index, a non-invasive nociception monitor. Anesthesiology July 2016, Vol.125, 193-203

  • 8. Martini C.H. et al (2015),  Ability of the Nociception Level (NOL), a multiparameter composite of autonomic signals, to detect noxious stimuli during propofol-remifentanil anesthesia. Anesthesiology Sept. 2015; 123:524-534

  • 9. Meijer, F. et al (2019). Nociception-guided versus Standard Care during Remifentanil–Propofol Anesthesia: A Randomized Controlled Trial. Anesthesiology, 130(5), 745-755. doi:10.1097/ALN.0000000000002634