The Awakening Index

The Awakening Index mirrors how forceful the skin sympathetic nerves are firing to tailor the need of  analgesia / antinocicepive drugs when the patient is waking up from sedation, a forceful warning for need of antinociceptive drugs.

The Awakening Index can be used also during ketamine and alfa-2 agonists when the indices of EEG monitors (BIS, Narcotrend and Sedline) is misleading as well as adding information when the EEG monitors increase due to too little anti-nociceptive drugs or too little hypnotics. The Awakening index will only increase when it is too little antinociceptive drugs, e.g waking up after surgery when the level of analgesia / anti-nociceptive drugs are appropriate:

Reference: Storm H, Støen R, Klepstad P, Skorpen F, Qvigstad E, Ræder J. Nociceptive stimuli responses at different levels of general anaesthesia and genetic variability. Acta Anaesthesiol Scand 2013; 57: 89–99.