{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:10:04Z","timestamp":1789027804096,"version":"build-2803163510"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Monit Comput"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We investigated whether pre-induction High Frequency Variability Index (HFVI)\/Analgesia Nociception Index (ANI) and Nociception Level (NOL) values could predict hypotension during general anesthesia induction in older patients. This prospective observational study included patients aged\u2009\u2265\u200965 years undergoing elective surgery under general anesthesia. After recording HFVI\/ANI and NOL values, remifentanil was administered at 0.2 \u00b5g\/kg\/min for 2 min, followed by a rapid intravenous bolus administration of propofol at 2 mg\/kg. Noninvasive blood pressure was measured at 1-min intervals over 5 min. Hypotension was defined as mean arterial pressure (MAP)\u2009&lt;\u200965 mmHg. Predictive performance was evaluated using receiver operating characteristic (ROC) curves. Additionally, the area under MAP\u2009&lt;\u200965 mmHg (AUT-65), a continuous metric integrating the depth and duration of hypotension, was calculated and correlated with nociception index values. We analyzed 51 patients (19 men; 22 in the hypotension group and 29 in the nonhypotension group). The hypotension group demonstrated lower HFVI\/ANIi values (58.7\u2009\u00b1\u200911.1 vs. 69.0\u2009\u00b1\u200915.1,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.010) and higher NOL values (17.2\u2009\u00b1\u20099.1 vs. 10.7\u2009\u00b1\u20098.8,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.013). HFVI\/ANIi (AUC\u2009=\u20090.72, cutoff\u2009=\u200962.5) and NOL (AUC\u2009=\u20090.71, cutoff\u2009=\u200913.5) moderately predicted hypotension. AUT-65 was significantly correlated with HFVI\/ANIi (Spearman rho\u2009=\u2009\u2212\u20090.35,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.013) and NOL (rho\u2009=\u20090.47,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0005). Pre-induction HFVI\/ANI and NOL were associated with the occurrence and cumulative burden of post-induction hypotension in patients aged\u2009\u2265\u200965 years, suggesting their potential utility as pre-induction screening tools.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Trial registration<\/jats:italic>\n                    This study was approved by the Ethics Committee of Yamagata University Hospital on January 18, 2024 (approval number 2023\u2009\u2212\u2009280). Before commencement, the study was registered as a prospective observational study in the UMIN Clinical Trials Registry (UMIN000053529).\n                  <\/jats:p>","DOI":"10.1007\/s10877-026-01469-1","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:42:54Z","timestamp":1784029374000},"page":"1033-1043","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-induction nociception indices are associated with post-induction hypotension during general anesthesia in older patients: a prospective observational study"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-3226","authenticated-orcid":false,"given":"Masahiro","family":"Kuroki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Tsunoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Hayasaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenya","family":"Yarimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayuka","family":"Narisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Toyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"1469_CR1","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1007\/s00540-011-1152-1","volume":"25","author":"V Tassoudis","year":"2011","unstructured":"Tassoudis V, Vretzakis G, Petsiti A, Stamatiou G, Bouzia K, Melekos M, Tzovaras G. 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The study was prospectively registered in the UMIN Clinical Trials Registry (UMIN000053529) before patient enrollment. All participants provided written informed consent after receiving detailed explanation of the study procedures. Patients were informed of their right to withdraw consent at any time without any adverse effect on their medical care.","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This study presents aggregated data only, and no individual patient data that could lead to identification of participants are included.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}