Optimization of Morphinomimetic Administration Intraoperatively: Evaluation of the Impact of the NOL Index on the Occurrence of Postoperative Adverse Events Related to Morphinomimetics

Inclusion criteria

• Male or female
• Subject aged ≥ 18 years
• Affiliated with a social security scheme
• Having given written informed consent to participate study
• Admitted for major surgery expected to last more than 2 hours
• Under general anesthesia with tracheal intubation
• For a planned hospital stay of at least 48 hours
• Participant's ability to understand the nature and objectives of the study to comply with study requirements.

Exclusion criteria

• Contraindication to one of the drugs used for anesthesia
• Urgent surgery
• Intracranial surgery
• Transplant surgery
• Cardiac surgery
• Surgery with scheduled local anesthesia
• Patient requiring postoperative intubation
• Neuromuscular disease
• Patient chronically using morphinomimetics
• Chronic pain patient
• Patients with a history of sleep apnea
• Conditions likely to interfere with photoplethysmograph signal acquisition or skin conductance (excessive or tremors of the extremities, skin lesions or burns)
• Patients wearing false nails and/or nail polish
• Contraindication to the use of the PMD 200 ™ medical device (including cardiovascular resuscitation and cardioversion/defibrillation);
• Patient with an implanted pacemaker or defibrillator
• Treatment with β-blockers
• Preoperative cardiac arrhythmia
• Pregnant or breast-feeding women. A β-HCG test will be systematically performed prior to inclusion of non-menopausal women menopausal women
• Patients under legal protection (safeguard of justice, curatorship guardianship) or deprived of liberty
• Participation in other interventional research involving an experimental drug or medical device.