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<p><i>Background</i> The Analgesia–Nociception Index (ANI), derived from heart rate variability, reflects parasympathetic activity and is used to assess intraoperative nociception. β-blockers modulate autonomic tone and heart rate variability and may influence responses to nociceptive stimuli. This study investigated whether preoperative β-blocker use was associated with altered intraoperative ANI dynamics during laparoscopic cholecystectomy. <i>Method</i> The data of 49 patients with hypertension who underwent elective laparoscopic cholecystectomy under a standardized propofol–remifentanil anesthetic protocol were analyzed in this prospective observational study. Patients were classified according to chronic β-blocker use (β-blocker group, n = 24; non-β-blocker group, n = 25). Four predefined nociceptive stimuli were applied under stable anesthetic conditions. The minimum ANI value within 2 min after each stimulus (ANI_min) and the change from the pre-stimulus value (ΔANI) were analyzed using repeated-measures analysis of variance. <i>Results</i> Repeated-measures ANOVA demonstrated a significant main effect of time, indicating a consistent decrease in ANI in response to standardized nociceptive stimuli. No significant time × group interaction or main effect of group was observed for ANI_min or ΔANI. The temporal patterns and magnitudes of ANI changes were comparable between groups across all predefined time points. <i>Conclusions</i> Preoperative β-blocker therapy did not substantially alter stimulus-related ANI dynamics during laparoscopic cholecystectomy under propofol–remifentanil anesthesia. These findings suggest that ANI may remain interpretable as a dynamic within-patient autonomic response in chronically β-blocked patients under these anesthetic conditions.</p>

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Effect of preoperative β-blocker use on Analgesia–Nociception Index during laparoscopic cholecystectomy

  • 期刊论文

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  • 发表日期：

    2026年6月18日

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  • Joon-suk Bom,
  • Seongheon Lee,
  • Ye-chan Yoo,
  • Joungmin Kim

摘要

Background The Analgesia–Nociception Index (ANI), derived from heart rate variability, reflects parasympathetic activity and is used to assess intraoperative nociception. β-blockers modulate autonomic tone and heart rate variability and may influence responses to nociceptive stimuli. This study investigated whether preoperative β-blocker use was associated with altered intraoperative ANI dynamics during laparoscopic cholecystectomy. Method The data of 49 patients with hypertension who underwent elective laparoscopic cholecystectomy under a standardized propofol–remifentanil anesthetic protocol were analyzed in this prospective observational study. Patients were classified according to chronic β-blocker use (β-blocker group, n = 24; non-β-blocker group, n = 25). Four predefined nociceptive stimuli were applied under stable anesthetic conditions. The minimum ANI value within 2 min after each stimulus (ANI_min) and the change from the pre-stimulus value (ΔANI) were analyzed using repeated-measures analysis of variance. Results Repeated-measures ANOVA demonstrated a significant main effect of time, indicating a consistent decrease in ANI in response to standardized nociceptive stimuli. No significant time × group interaction or main effect of group was observed for ANI_min or ΔANI. The temporal patterns and magnitudes of ANI changes were comparable between groups across all predefined time points. Conclusions Preoperative β-blocker therapy did not substantially alter stimulus-related ANI dynamics during laparoscopic cholecystectomy under propofol–remifentanil anesthesia. These findings suggest that ANI may remain interpretable as a dynamic within-patient autonomic response in chronically β-blocked patients under these anesthetic conditions.