Pain assessment using the Analgesia Nociception Index in patients undergoing sedation: a systematic review and meta-analysis

This systematic review and meta-analysis analyzed the utility of the Analgesia Nociception Index (ANI) in detecting intraoperative and procedural pain in sedated patients. A comprehensive search of the Cochrane Central Register of Controlled Trials, Ovid-MEDLINE, Ovid-Embase, and Google Scholar databases was performed to identify relevant studies. The primary outcome was the diagnostic accuracy of ANI, assessed by pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR). Secondary outcomes were the correlation between ANI and pain assessment scales, the effect of norepinephrine (NE) on ANI, and differences in opioid consumption between the ANI-guided and control groups.