Nociception-guided opioid administration within multimodal analgesia for laparoscopic endometriosis surgery: a randomized controlled trial.

Hoang-Thi Buis, Joana Berger-Estilita, Sina Zirngast, Paul Ranner, Tihomir Piskor, Isabel Marcolino
2026 · doi:10.48620/98802 · W7165689617
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⚙ AI-generated summary by claude@2026-07, 2026-07-09 ⓘ

Nociception Level (NOL)-guided opioid administration did not reduce perioperative opioid consumption or improve early postoperative outcomes compared to standard multimodal analgesia in women undergoing laparoscopic endometriosis surgery.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

I’m not able to access the paper content you provided because the text shown is an anti-bot page rather than the research article itself, so I can’t summarize its methods or findings without the actual study text (e.g., abstract/results). If you paste the abstract and the key results (or the full article text), I can summarize it in 3–5 sentences as requested. The paper title indicates it is about laparoscopic endometriosis surgery and opioid administration guided by nociception, so its intended relationship to endometriosis is direct, but I can’t confirm specific details from the unavailable content. This paper is centrally about endometriosis — it studies nociception-guided opioid administration within multimodal analgesia for laparoscopic endometriosis surgery.

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Abstract

Women with endometriosis are at increased risk of severe postoperative pain due to nociceptive sensitization. While multimodal analgesia reduces opioid use, the added value of objective nociception monitoring remains unclear. This study evaluated whether NOL®-guided opioid titration improves perioperative outcomes within a standardized multimodal regimen. In this prospective, randomized, single-blinded trial, premenopausal women undergoing laparoscopic surgery for suspected endometriosis or adenomyosis were assigned to NOL®-guided analgesia or standard care based on clinical assessment. All patients received a standardized multimodal protocol. The primary outcome was total perioperative opioid consumption. Secondary outcomes included postoperative pain scores (NRS) and PACU length of stay. Exploratory analyses assessed the association between preoperative pain (Mankoski Pain Scale, MPS) and postoperative outcomes. A total of 111 patients were analyzed (NOL®: n = 54; control: n = 57). Total perioperative opioid consumption did not differ significantly between groups (adjusted mean difference = 14 μg for Fentanyl and 52 μg for Remifentanil; p = 0.8). Surgery duration was an independent predictor of opioid use (p < 0.001) and PACU length of stay (p = 0.01), whereas treatment group had no significant effect. Postoperative pain scores were comparable between groups at all time points. NOL®-derived metrics were not associated with opioid consumption or pain. Higher preoperative MPS scores independently predicted higher pain scores in the late PACU phase. NOL®-guided opioid titration did not reduce perioperative opioid consumption or improve early postoperative outcomes compared with standard multimodal analgesia in women undergoing laparoscopic surgery for endometriosis.
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