Anesthesia, Child, Pain
Conditions
Keywords
Intraoperative Neurophysiological Monitoring, Reflex, Pupillary, remifentanil
Brief summary
The aim of this prospective randomized study is to evaluate the impact of peroperative pupillometry monitoring on per and post-operative opioid consumption in pediatric anesthesia. All patients are anesthetized with sevoflurane and remifentanil. In the intervention group, peroperative remifentanil infusion rate is guided by pupillometry. In the other group, remifentanil infusion rate is guided according to hemodynamic data.
Interventions
DRUGRemifentanil
DEVICEPupillometry
Pupillary diameter measured every 5 minutes
DRUGSevoflurane
Administered to maintain a Bispectral Index between 40 and 60
Sponsors
University Hospital, Geneva
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
2 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
* Children scheduled for a surgery lasting more than 90 minutes.
Exclusion criteria
* Contraindication to sevoflurane, to remifentanil or to morphine. * Peripheral or central nerve block during and after surgery. * Ophthalmological disease. * Peroperative position with no acess to the head. * Chronic use of medication interfering with pupillary diameter. * Ambulatory surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| peroperative remifentanil consumption | duration of surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Morphine consumption | during the 24 hour post operative period | — |
| Incidence of morphine side effects | during the 24 hour post operative period | Sedation, nausea, vomiting, pruritus, urinary retention |
| Pain scoring (verbal numerical scale) | during the 24 hour post operative period | — |
| Pain scoring (questionnaire) | one month post-operatively | — |
Countries
Switzerland
Outcome results
None listed