Prediction of movement to surgical stimulation by the pupillary dilatation reflex amplitude evoked by a standardized noxious test

Anesthesiology
Jean GuglielminottiDan Longrois

Abstract

Individual assessment of the amplitude of a physiologic reflex evoked by a standardized noxious test (SNT) before surgical stimulation has been suggested to predict movement upon the forthcoming surgical stimulation. This study aimed to compare the ability of pupillary dilatation reflex amplitude (PDRA) evoked by an SNT and estimated remifentanil effect-site concentration (Ce) to predict movement upon surgical stimulation. Eighty female patients were anesthetized for vacuum aspiration with propofol (Ce 4 μg/ml) and remifentanil. Remifentanil Ce was randomized to 0, 1, 3, or 5 ng/ml. SNT was a 60-mA, 5-s, 100-Hz tetanus applied on median nerve before cervix dilatation. PDRA was calculated as the difference in pupillary diameter after and before SNT. Movement upon cervix dilatation was recorded by an independent observer. Ability of PDRA and estimated remifentanil Ce to discriminate movers from non-movers during cervix dilatation was measured as the area under the receiver operating characteristics curve. Twenty-one of the 76 patients analyzed moved during cervix dilatation. Mean PDRA (±1 SD) evoked by SNT was 2.0 ± 1.2 mm in movers and 0.6 ± 0.7 in non-movers (P < 0.0001). Remifentanil Ce was 0.2 ± 0.4 ng/ml in movers and 3.0 ± ...Continue Reading

Associated Clinical Trials

References

May 1, 1993·Anesthesia and Analgesia·M D LarsonJ McGuire
Jun 9, 1999·Anesthesiology·T W SchniderE J Youngs
Aug 20, 2003·British Journal of Anaesthesia·L BarvaisG N Kenny
Oct 25, 2003·Anesthesiology·Talmage D Egan, Steven L Shafer
Nov 26, 2003·Anesthesiology·Laura L YangMerlin D Larson
May 15, 2009·Anesthesia and Analgesia·Nicolas MongardonJean Guglielminotti
Mar 18, 2010·Anesthesiology·Patrick RayTim T Houle
Jun 1, 2011·British Journal of Anaesthesia·M M R F StruysA R Absalom
Jan 31, 2013·Anesthesiology·Hugo E M VereeckeMichel M R F Struys
Mar 13, 2013·Anesthesia and Analgesia·Jean GuglielminottiDan Longrois

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Citations

Dec 15, 2015·Anesthesiology·Koffi M KlaMark J Rice
Dec 15, 2015·Anesthesiology·Jean Guglielminotti, Dan Longrois
Dec 13, 2016·Anesthesia and Analgesia·Andrew E NeiceMerlin D Larson
Apr 20, 2018·Acta Anaesthesiologica Scandinavica·D WildemeerschG Hans
Oct 19, 2017·Journal of Clinical Monitoring and Computing·Nada SabourdinIsabelle Constant
Apr 19, 2019·Anesthesia and Analgesia·Marc VinclairJean-Francois Payen
May 20, 2015·Anesthesiology·Jonathan P Wanderer, James P Rathmell
Mar 10, 2017·Journal of Clinical Monitoring and Computing·Eric YangPaul S García
May 24, 2019·Journal of Clinical Monitoring and Computing·Sérgio VidePedro Amorim
Nov 20, 2019·Anesthesia and Analgesia·Marc VinclairJean-Francois Payen
Jan 13, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Senthil PackiasabapathySenthilkumar Sadhasivam
Aug 24, 2021·Der Anaesthesist·Rainer NitzschkeSandra Funcke
Sep 3, 2021·Palliative Medicine·Antoine ElynMerlin Larson

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