BACKGROUND The QNox score (Quantium Medical S.L., distributed by Fresenius Kabi) has recently been introduced as a tool to quantify intraoperative analgesia. Being based on the analysis of electroencephalographic data, QNox is distinctly different to other methods of nociception monitoring that rely almost entirely on the assessment of sympathetic activity. However, there are currently no published data to validate use of QNox in a clinical setting. We investigated the value of pre-arousal QNox data at the end of surgery for prediction of acute postoperative pain in the PACU. METHODS A total of 150 patients scheduled for non-emergency surgery under sevoflurane-opioid general anaesthesia were included in the study. At the end of surgery but before patient arousal, QNox was measured minutely for 5 min. After admission to the recovery room, pain scores (numeric rating scale [NRS], 0-10) were obtained 5 minutely for 15 min. RESULTS Data from 144 patients were analysed. QNox before arousal showed no correlation (ρ=0.057) with acute postoperative pain in the PACU. Furthermore, the score was found to have no value for the prediction of acute postoperative pain (area under the receiver operating curve, 0.501; 95% confidence interval, 0.406-0.597). CONCLUSION QNox at the end of surgery before arousal showed no association with and allowed no prediction of acute pain in the PACU. CLINICAL TRIAL REGISTRATION ACTRN12618001662257.

中文翻译：

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在手术结束时通过Qnox评分预测急性术后疼痛：一项前瞻性观察性研究。

背景技术QNox评分（Quantium Medical SL，由费森尤斯·卡比（Fresenius Kabi）发行）最近被引入作为量化术中镇痛的工具。基于脑电图数据的分析，QNox与其他几乎完全依赖于交感神经活动评估的伤害感受监测方法截然不同。但是，目前尚无公开的数据来验证QNox在临床环境中的使用。我们调查了术前Qarx数据在预测PACU术后急性疼痛中的价值。方法本研究共纳入150例计划在七氟醚-阿片类药物全身麻醉下进行非紧急手术的患者。在手术结束时但在患者唤醒之前，每5分钟对QNox进行一次测量。进入康复室后 每15分钟5分钟获得一次疼痛评分（数字评分量表[NRS]，0-10）。结果分析了144例患者的数据。唤醒前的QNox与PACU的急性术后疼痛无相关性（ρ= 0.057）。此外，发现该分数对预测急性术后疼痛没有价值（接受者手术曲线下的面积为0.501； 95％的置信区间为0.406-0.597）。结论QNox于手术结束前在唤醒前未显示与PACU相关的急性疼痛，也无法预测其急性疼痛。临床试验注册ACTRN12618001662257。发现该分数对预测急性术后疼痛没有价值（接受者手术曲线下的面积为0.501； 95％的置信区间为0.406-0.597）。结论QNox于手术结束前在唤醒前未显示与PACU相关的急性疼痛，也无法预测其急性疼痛。临床试验注册ACTRN12618001662257。发现该分数对预测急性术后疼痛没有价值（接受者手术曲线下的面积为0.501； 95％的置信区间为0.406-0.597）。结论QNox于手术结束前在唤醒前未显示与PACU相关的急性疼痛，也无法预测其急性疼痛。临床试验注册ACTRN12618001662257。