Pain Assessment by Pupil Dilation Reflex (PDR) and Pupillary Pain Index (PPI) in Response to Noxious Stimulation in Anesthetized Adults
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University Hospital, Antwerp
- Enrollment
- 34
- Locations
- 1
- Primary Endpoint
- Stimulation Intensity
Study Overview
Brief Summary
After conduction a pilot study, pupillary dilation reflex (PDR) is measured in response to nociceptive stimulation perioperatively.
Detailed Description
An infrared camera of the video pupillometer measures the pupillary dilation reflex (PDR) in response to incremental nociceptive stimuli. The PDR is a robust reflex, even in patients under general anesthesia, and may provide a potential evaluation of the autonomous nociceptive circuit. American Society of Anesthesiologists (ASA) classification I or II patients undergoing elective surgery under general anesthesia are recruited. Enrolled patients perioperative undergo PDR measurement at 2 different standardized times (before and after opioid administration) generated by an inbuilt pupillary pain index (PPI) protocol. PPI, as a surrogate for nociception includes noxious stimulations from 10 up to 60 milli ampere (mA) until pupil dilation is larger than 13% from baseline diameter. Therefore, no inappropriate high stimulation is executed.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Diagnostic
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Scheduled abdominal or gynecological surgery
Exclusion Criteria
- •History of eye deformity, invasive ophthalmologic surgery
- •Known cranial nerve(s) deficit
- •Infection of the eye
- •Predicted difficult airway management (DAF Guidelines)
- •Chronic opioid use (>3 months)
- •Ongoing treatment with beta-blockers, dopamine antagonists, topical atropine
- •Preoperatively administrated benzodiazepins or antiemetics
Arms & Interventions
PDR measurement
Two measurements of PDR perioperatively before and after opioid administration
Intervention: PDR measurement (Procedure)
Outcomes
Primary Outcomes
Stimulation Intensity
Time Frame: During perioperative period
Necessary stimulation intensity to dilate the pupil more than 13%
Secondary Outcomes
- Systolic blood pressure(During PDR measurements)
- Pupillary Pain Index score(During perioperative period)
- Heart rate(During PDR measurements)
Investigators
Davina Wildemeersch
MD
University Hospital, Antwerp