CClinicalTrials.gg
CompletedNCT02916004Updated May 15, 2023

The Use of Nociception Flexion Reflex and Pupillary Dilatation Reflex in ICU Patients.

An interventional study of Measurement of NFR and PDR in Critical Illness, sponsored by University Hospital, Antwerp. Completed at 1 site in Belgium. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-05-15.

Sponsored by University Hospital, Antwerp · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The aim of the study was to describe the feasibility of the nociception flexion reflex and the pupillary dilatation reflex as objective pain assessment tools in the Intensive Care Unit (ICU). Furthermore to describe the relationship between the responses and the standard of care pain evaluation in the critically ill sedated patients.

Patients were under propofol / remifentanil or propofol / sufentanil sedation protocol during measurements in a stair-case increasing intensity model of standardized stimulations. (Stimulation intensity are similar to the stimulations of neuromuscular blocking agents monitoring.)

Read the detailed description

Pupillary dilatation reflex: tetanic stimulations at the nervus medianus were performed starting form 10 milliamperes (mA) up to 60mA. Pupillary diameter was measured before, during and after stimulation.

Nociception flexion reflex: tetanic stimulations at the nervus suralis were performed starting form 0.5mA in increasing steps via an automated RIII (NFR) threshold tracking model.

02

Conditions studied

  • Critical Illness

Keywords

  • Analgesia
  • Pain measurement
  • Nociception
  • Electromyography
  • Electrical stimulation
  • Pupillometry
  • Critical care
  • Sedation
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older
  • Critically ill with necessity to mechanic ventilation
  • Hospitalized at the ICU of our institution
  • Started sedation protocol (propofol/remifentanil or propofol/sufentanil)
  • Approved informed consent by family member or relative.

Exclusion criteria

Exclusion Criteria:

  • Known eye deformity or extented ophthalmologic surgery in history
  • Severe traumatic brain injury of fulminant stroke
  • Known (poly)neuropathy of complicated diabetes
  • Need for continuously curarization
  • Hemodynamic instability
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Other
    Measurement of NFR and PDR

    Diagnostic intervention: excite NFR and PDR in comparison to behavior pain scale (BPS)

    Device: Measurement of NFR and PDR

Interventions

  • DeviceMeasurement of NFR and PDR

    Feasibility testing of NFR and PDR in sedated, ventilated patients. Comparison of NFR and PDR with standard routine care of pain assessment

05

What researchers measure

Primary outcomes

  1. Test the feasibility of a objective pain evaluation tool; the nociception flexion reflex (NFR)

    Time frame: 10 seconds after nociceptive stimulation

  2. Test the feasibility of a objective pain evaluation tool; the pupillary dilatation reflex (PDR)

    Time frame: 10 seconds after nociceptive stimulation

Secondary outcomes

  1. Comparison NFR and the standard of care pain assessment (behavior pain scale)

    Routine assessment of pain by attending nurse

    Time frame: In period of routine two hourly check up by nurse

  2. Comparison PDR and the standard of care pain assessment (behavior pain scale)

    Routine assessment of pain by attending nurse

    Time frame: In period of routine two hourly check up by nurse

06

Study locations

1 site
  • University hospital Antwerp
    Edegem, Antwerpen 2650, Belgium
07

Registry details

Key details

Study ID
NCT02916004
Lead sponsor
University Hospital, Antwerp
Responsible party
Davina Wildemeersch (MD, University Hospital, Antwerp) — Principal investigator
First posted
Sep 27, 2016
Start date
Sep 26, 2016
Primary completion
Nov 30, 2017
Completion
Jul 14, 2018
Last update
May 15, 2023

Study contacts

Davina Wildemeersch, MD
principal investigator · University Hospital, Antwerp

Oversight

Data monitoring committee
No
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