Résumé
The management of the comfort of patients in intensive care is fundamental because of the invasive nature of the care and the criticism of the situation which is associated with many states of post-traumatic stress in surviving patients. The Analgesia Nociception Index (ANI) is a tool currently used to monitor pain, ranging from 0 (predominant sympathetic tone, maximum pain) to 100 (predominant parasympathetic tone, no pain). In this ancillary study of an interventional study evaluating different relaxation techniques, we explore the association between ANI and different symptoms of suffering, with the hypothesis that ANI is not a specific measure of pain.Methods: discomfort, pain, anxiety, dyspnea, thirst and lack of rest, which are the main symptoms associated with suffering in intensive care, were measured as well as ANI before and after 4 periods of randomized 15-minutes relaxation: standard relaxation, Music CareÓ music therapy, Deepsenâ virtual reality (VR) headset (real images) or Healthy Mindâ (synthetic images). The primary outcome was the correlation between ANI values and the 0-10 numerical scales measured by the Spearman coefficient.Results: 404 evaluations were analyzed in 60 patients. ANI was significantly correlated with pain (r= -0.13; p= 0.006), discomfort (r= -0.13; p= 0.007), anxiety (r= -0.12; p= 0.02) and lack of rest (r= -0.11; p= 0.03), but not thirst or dyspnea. There was a significant difference between the ANI/pain correlation and the ANI/thirst and dyspnea correlation, but the difference was not significant between the ANI/pain correlation and the ANI/discomfort, anxiety and lack of rest correlation (p> 0.7; Hotelling - William method).Conclusion: ANI is not only as the name suggests a marker of pain and nociception, but rather a marker of more general suffering, including other symptoms of stress.