Pupillary dilation reflex and pupillary pain index evaluation during general anaesthesia: a pilot study

Romanian Journal of Anaesthesia and Intensive Care
D WildemeerschG Hans

Abstract

Pupillary response by pupillary dilatation reflex (PDR) is a robust reflex, even measurable during general anaesthesia. However, the ability of infrared pupillometry to detect PDR differences obtained by intraoperative opioid administration in anaesthesized patients remains largely unknown. We analyzed the performance of automated infrared pupillometry in detecting differences in pupillary dilatation reflex response by a inbuilt standardized nociceptive stimulation program in patients under general anesthesia with a standardized propofol/fentanyl scheme. In this single center, interventional cohort study 38 patients (24-74 years) were enrolled. Patients were anesthetized with propofol until loss of consciousness. Two dynamic pupil measurements were performed in each patient (before opioid administration and after opioid steady state). Automated infrared pupillometry was used to determine PDR during nociceptive stimulations (10-60 mA) applied by a inbuilt pupillary pain index protocol (PPI) to the skin area innervated by the median nerve. Increasing stimulations by protocol are device specific and automatically performed until pupil dilation of > 13%. Pupil characteristics, blood pressure, heart rate values were collected. After...Continue Reading

Citations

Apr 30, 2019·Scandinavian Journal of Pain·Ulf E Kongsgaard, Gudrun Høiseth
Feb 18, 2021·Deutsches Ärzteblatt International·Felix BartholmesChristine H Meyer-Frießem
Jul 6, 2021·Frontiers in Neuroscience·Babak ZandiTran Quoc Khanh

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