Pupil diameter during postanesthetic recovery is not influenced by postoperative pain, but by the intraoperative opioid treatment
| Autor: | B. Abbal, Hugues Julien, Charlotte Baud, Bruno Pereira, Christian Dualé, Pierre Schoeffler |
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| Přispěvatelé: | CIC Clermont Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-Centre de Pharmacologie Clinique, CHU Clermont-Ferrand, Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), CHU Gabriel Montpied [Clermont-Ferrand], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Sufentanil Analgesic Remifentanil General anesthesia Pain Anesthesia General Pacu Cohort Studies 03 medical and health sciences 0302 clinical medicine Piperidines 030202 anesthesiology medicine Humans postoperative Prospective Studies Aged Pain Postoperative Intraoperative Care Dose-Response Relationship Drug biology business.industry Pupil Middle Aged biology.organism_classification Surgery Analgesics Opioid Alertness Anesthesiology and Pain Medicine Pupillometry Opioid Anesthesia Anesthesia Recovery Period Multivariate Analysis Female Analgesia business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology 030217 neurology & neurosurgery Follow-Up Studies Cohort study medicine.drug |
| Zdroj: | Journal of Clinical Anesthesia Journal of Clinical Anesthesia, Elsevier, 2015, 27 (1), pp.23-32. ⟨10.1016/j.jclinane.2014.09.006⟩ Journal of Clinical Anesthesia, 2015, 27 (1), pp.23-32. ⟨10.1016/j.jclinane.2014.09.006⟩ |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2014.09.006 |
| Popis: | Study Objective To investigate whether pupil diameter (PD) measured during scotopic conditions is influenced by pain in conscious patients in the early postoperative period. Design Prospective, observational, cohort study. Setting Single-center, postanesthesia care unit (PACU). Patients Patients scheduled for a surgery during general anesthesia. Interventions Baseline PD was measured the day before surgery. Patients were observed on admission to the PACU, immediately after extubation, during the different steps of analgesic intervention (demand, relief, plus intermediate measures when relevant), and either at discharge or 3 hours after admission. Measurements PD, pain (numerical rating scale), and alertness (Observer's Assessment of Alertness/Sedation scale). Main Results Of 103 patients enrolled, 80 required analgesia in the PACU and completed follow-up. Pain intensity evolved in line with expectations (temporary increase then relief), and alertness increased with time. PD increased from low mean values at admission to the PACU (40% of baseline) to a plateau throughout the rest of the study period (80% of baseline) and was not related to pain intensity. Multivariate analyses suggested that the factors influencing PD (or its value related to baseline) were time since extubation and the type of opioid (remifentanil, sufentanil, or sufentanil at high doses) administered during surgery. Conclusions Because of a residual effect of intraoperative opioids and a level of nociceptive stimulation lower than in surgical conditions, PD is not significantly influenced by early postoperative pain or pain relief. |
| Databáze: | OpenAIRE |
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