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CompletedNCT03140241Updated May 21, 2018

Pain Assessment by Pupil Dilation Reflex (PDR) and Pupillary Pain Index (PPI) in Response to Noxious Stimulation in Anesthetized Adults

An interventional study of PDR measurement in Nociceptive Pain and Monitoring, Intraoperative, sponsored by University Hospital, Antwerp. Completed at 1 site in Belgium. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2018-05-21.

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

Phase
Not applicable
Study type
Interventional
Enrollment
34
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

After conduction a pilot study, pupillary dilation reflex (PDR) is measured in response to nociceptive stimulation perioperatively.

Read the detailed description

An infrared camera of the video pupillometer measures the pupillary dilation reflex (PDR) in response to incremental nociceptive stimuli. The PDR is a robust reflex, even in patients under general anesthesia, and may provide a potential evaluation of the autonomous nociceptive circuit. American Society of Anesthesiologists (ASA) classification I or II patients undergoing elective surgery under general anesthesia are recruited. Enrolled patients perioperative undergo PDR measurement at 2 different standardized times (before and after opioid administration) generated by an inbuilt pupillary pain index (PPI) protocol. PPI, as a surrogate for nociception includes noxious stimulations from 10 up to 60 milli ampere (mA) until pupil dilation is larger than 13% from baseline diameter. Therefore, no inappropriate high stimulation is executed.

02

Conditions studied

  • Nociceptive Pain
  • Monitoring, Intraoperative
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Scheduled abdominal or gynecological surgery
  • ASA I-II

Exclusion criteria

Exclusion Criteria:

  • History of eye deformity, invasive ophthalmologic surgery
  • Known 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
  • Preoperatively administrated benzodiazepins or antiemetics
04

Study design

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

Study arms

  • Experimental
    PDR measurement

    Two measurements of PDR perioperatively before and after opioid administration

    Procedure: PDR measurement

Interventions

  • ProcedurePDR measurement

    PDR measurement at two standardized times perioperatively: 1. : anesthetized subject by propofol sedation until sedation depth monitor NeuroSense® (NeuroWave Systems Inc, Cleveland, OH) between 40-50 2. : administration of remifentanil via effect site target concentration (Minto-model) at 5 ng/ml, in the absence of adjustments in sedation depth

    Also known as: PPI assessment

05

What researchers measure

Primary outcomes

  1. Stimulation Intensity

    Necessary stimulation intensity to dilate the pupil more than 13%

    Time frame: During perioperative period

Secondary outcomes

  1. Pupillary Pain Index score

    Device specific PPI score defined in accordance to stimulation intensity necessary for pupil dilation more than 13%

    Time frame: During perioperative period

  2. Systolic blood pressure

    Hypertension as a common used parameter for perioperative nociceptive assessment

    Time frame: During PDR measurements

  3. Heart rate

    Tachycardia as a common used parameter for perioperative nociceptive assessment

    Time frame: During PDR measurements

06

Study locations

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

References and documents

Related links

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03140241
Lead sponsor
University Hospital, Antwerp
Responsible party
Davina Wildemeersch (MD, University Hospital, Antwerp) — Principal investigator
First posted
May 4, 2017
Start date
May 7, 2017
Primary completion
Jun 29, 2017
Completion
Jul 20, 2017
Last update
May 21, 2018

Study contacts

Michiel Baeten, MD
principal investigator · University Hospital, Antwerp
Natasja Peeters, MD
principal investigator · University Hospital, Antwerp
Vera Saldien, MD
study chair · University Hospital, Antwerp

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in May 2018. You cannot join it, but the record below documents what was studied.

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