Pain
Conditions
Keywords
Heart Rate, Reflex, Pupillary, Monitoring, Intraoperative
Brief summary
In this study, the pupillary dilation reflex is measured as a nociceptive indicator during elective abdominal surgery under general anesthesia.
Detailed description
An infrared camera of the video pupillometer measures the pupillary dilation reflex (PDR) in response of a nociceptive stimulus. This autonomic reflex, parasympathetic mediated in sedated patients, can be generated by various pain stimuli (built in standardized protocol, surgical incision, …) The PDR is a robust reflex, even in patients under general anesthesia, and provides a potential evaluation of the autonomous circuit within the nociceptive evaluation based on pupil dilation upon A-delta and C fibers in both electrical or mechanic stimulation. This mono-centric project involving American Society of Anesthesiologists (ASA) classification I-II patients undergoing elective abdominal surgery under general anesthesia are recruited. Enrolled patients perioperative undergo PDR measurements at four different standardized times.
Interventions
DEVICEPupil dilation reflex measurement
Pupillometry (PDR) at four standardized times perioperatively * after induction, before opioid administration * after opioid administration, steady state * surgical incision * end of procedure
Sponsors
University Hospital, Antwerp
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Scheduled abdominal surgery * ASA I-II
Exclusion criteria
* History of eye deformity, invasive ophthalmologic surgery, impaired pupil reflex in advance * Kown 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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pupillary Reflex Dilation | Perioperative phase | Pupillary Reflex Dilation is measured four times intraoperatively as a possible indicator of success of analgesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient Movement | Perioperative phase | Patient movement during surgery as a common used indicator for pain |
| Vital signs | Perioperative phase | Increased vital signs (heart rate, blood pressure) during surgery as a common used indicator for pain |
Countries
Belgium
Outcome results
None listed