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NOL® Monitoring


Optimize Pain Management

The PMD-200™ integrates the NOL® index to provide accurate, continuous and noninvasive nociception (pain response) monitoring for personalized analgesic treatment during surgery.

The Challenge

Intraoperative nociception and analgesia have traditionally been assessed indirectly through changes in heart rate / blood pressure – which are not sufficiently sensitive or specific.

Insufficient or excessive analgesia could lead to postoperative pain, complications, delayed recovery, and associated costs3, 4, 5.

UP TO 50%

of surgical patients suffer from moderate to severe post-operative pain.


Of surgical patients suffer from adverse events due to analgesic medications, leading to:

  • 3.3 extra days of hospitalization
  • 27% extra cost per patient
  • Increase in re-admissions

Our Solution

NOL Technology

The PMD-200™ by Medasense is a non-invasive and continuous pain monitoring device.

By using the PMD-200™ in operating rooms, where patients under general anaesthesia are unable to communicate their pain, clinicians are able to assess nociception, and tailor analgesic medication to meet the patient’s sensitivity and specific needs.

Multi-Parametric Approach

Recognizing the complex nature of pain, the PMD-200’s integrated NOL® (Nociception Level) technology considers multiple nociception-related physiological parameters and its various derivatives. Advanced algorithms process the multiple data streams, identify pain-related patterns, and reflect the patient’s nociceptive state.

NOL® Index

  • An objective indicator for the presence and severity of nociception.
  • The only multiparameter nociception index, based on the physiological integrated response to noxious stimuli.
  • Calibrated to the individual’s baseline.
  • Clinically validated as superior to other nociception indicators.

Improved Outcomes

NOL® Index

Clinical studies have shown that NOL-guided intraoperative analgesia can achieve:

  • 33% less postoperative pain6
  • 30% reduction in opioid consumption during surgery1
  • 80% fewer intraoperative hypotensive events1
  • ROI in less than one year of purchase,7

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  1. Meijer, F., Martini, C., Broens, S., Boon, M., Niesters, M., Aarts, L., Olofsen, E., van Velzen, M., Dahan, A. (2019). Nociception-guided versus Standard Care during Remifentanil–Propofol Anesthesia: A Randomized Controlled Trial. Anesthesiology, 130(5), 745-755. doi:10.1097/ALN.0000000000002634
  2. Edry, R., Recea, V., Didust, Y. & Sessler, D. I. (2016). Intraoperative validation of the NOL Index, a non-invasive nociception monitor. Anesthesiology, 125, 193-203.
  3. Gan TJ et al., (2014), Incidence, patient satisfaction, and perceptions of post-surgical pain: Results from a US national survey. Current Medical Research and Opinion, 30:149–6.
  4. Pogatzki-Zahn E et al., (2015), A Prospective Multicenter Study to Improve Postoperative Pain: Identification of Potentialities and Problems. PLoS ONE, 10 (11):
  5. Oderda G et al., (2013), Effect of Opioid-Related Adverse Events on Outcomes in Selected Surgical Patients. J Pain Palliat Care Pharmacother. 27:62-70.
  6. Meijer, F. et al., (2020), Reduced postoperative pain using Nociception Level-guided fentanyl dosing during sevoflurane anaesthesia: a randomised controlled trial. British Journal of Anaesthesia. 125(6):1070-1078. DOI:https://doi.org/10.1016/j.bja.2020.07.057.
  7. Saunders R., Weissbrod R. Cost benefit of personalizing intraoperative pain management. ISPOR Virtual Conference, May 2020.