Intraoperative Use of Infrared Pupillometry During General Anesthesia to Predict Pain and Quality of Regional Anesthesia After Surgery
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 24
- 试验地点
- 1
- 主要终点
- Pain in Recovery Room
研究概览
简要总结
The study comprises of a series of pupillary measurements using infrared pupillometry in patients undergoing arthroscopic knee surgery of any type.
Infrared pupillometry will be used to assess whether a painful stimulus results in pupillary reflex dilation (PRD). The extend of the PRD may be an indicator how painful a stimulus is. This may help to predict the amount of discomfort a patient will be experiencing after emergence from general anesthesia.
In addition to measuring the pupillary reflex dilation, we will also measure oscillations of pupil size before and after indiction of anesthesia, as well as during recovery. These spontaneously occuring oscillations in pupil size, also called hippus, appear to be sensitive to anesthetics and opioids. However, the effect of these drugs on hippus has not been systematically addressed.
The aim of the study is
- to identify whether regional anesthesia techniques such as femoral and sciatic nerve blocks will block the PRD. This would allow assessment of block success in the anesthetized patient.
- to correlate the extent of the pupillary reflex dilation and hippus in the anesthetized patient during and at the end of surgery with early postoperative pain scores and subsequent analgesia requirements. Such correlation would allow to predict the amount of postoperative pain before the patients emerge from general anesthesia.
详细描述
The planned study is a prospective cohort study.
Patients undergoing arthroscopic knee surgery of any type (debridements, repair of anterior (ACL) or posterior cruciform ligaments (PCL), meniscectomies, medial (MCL) or lateral collateral ligament (LCL) repair, as well as microfracture surgery will be enrolled.
During anesthesia, infrared pupillometry will be used to assess whether a painful stimulus results in pupillary reflex dilation (PRD). The extend of the PRD may be an indicator how painful a stimulus is. The PRD is measurable under general anesthesia in spite of the fact that the patient does not "feel" or experience the painful stimulus.
The aim of the study is
- to identify whether regional anesthesia techniques such as femoral and sciatic nerve blocks (performed before the start of anesthesia) will block the PRD evoked by a painful stimulus such electrical stimulation before procedure start. This would allow assessment of block success in the anesthetized patient.
- to correlate the extent of the pupillary reflex dilation and hippus in the anesthetized patient during and at the end of surgery with early postoperative pain scores and subsequent analgesia requirements. Such correlation would allow to predict the amount of postoperative pain before the patients emerge from general anesthesia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 99 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients older than 18 years undergoing arthroscopic knee surgery of any type
排除标准
- •Blindness
- •Anisocoria
- •History of opioid abuse
- •Chronic pain patients
- •Gastric Reflux Disease (due to the use of laryngeal masks in the study)
- •Non english speaking patients
- •Cognitive impairment
研究组 & 干预措施
Intervention Group
all enrolled patients undergo the same protocol/ treatment:
Anesthesia Premedication, Induction and Maintenance Pupillometry after administration of anesthetic drugs
干预措施: Anesthesia Premedication, Induction and Maintenance (Drug)
Intervention Group
all enrolled patients undergo the same protocol/ treatment:
Anesthesia Premedication, Induction and Maintenance Pupillometry after administration of anesthetic drugs
干预措施: Pupillometry after administration of anesthetic drugs (Procedure)
结局指标
主要结局
Pain in Recovery Room
时间窗: at arrival in recovery room
Pain as assessed by visual analogue score at arrival of the patient in the recovery room Scale goes from 0-10, with 10 indicating the worst pain possible
次要结局
- Number of Patients we Were Able to Elicit a PLR Under Stable Experimental Conditions(measurements were taken at two time points during surgery. Each measurement took 30 seconds)
研究者
Matthias Behrends
Associate Clinical Professor
University of California, San Francisco