AI Article Synopsis
- The study investigates using pupillometry, a noninvasive method to measure pupillary reflex dilation (PRD), to assess nociception and guide opioid use during surgery in children under general anesthesia.
- Researchers conducted a trial with 72 pediatric patients, measuring changes in pupil diameter in response to surgical pain and tracking fentanyl administration.
- Results showed a significant increase in pupil size after surgery due to pain, suggesting that monitoring pupil dilation can effectively guide opioid dosing in anesthetized children.
Article Abstract
Background and objective The management and treatment of nociception remain one of the major challenges in anesthesiology, and hemodynamic variations may occur due to inadequate analgesia, which at times can be injurious. Pupillometry is a new noninvasive tool to assess nociception during anesthesia. The amount of pupillary reflex dilation (PRD) is directly proportional to the intensity of nociceptive stimuli and inversely proportional to the opioid dosage. This study aimed to assess the use of pupillometry as reflex pupillary dilatation in response to surgical stimulus in children under general anesthesia and to guide intraoperative opioid consumption. Materials and methods After obtaining approval from the institutional ethics committee and written consent from parents, children with an American Society of Anesthesiology (ASA) classification of I and II and aged 2-12 years who were undergoing surgery under general anesthesia were enrolled in this prospective randomized observational study. General anesthesia was standardized with propofol, sevoflurane, and O and NO (50:50%), and fentanyl administration was guided by pupil diameter changes. The primary outcome was to measure pupillary dilatation in response to pain and fentanyl administration guided by it. Results A total of 72 patients were included in the study. The mean pupil diameter significantly increased after surgical stimulus from 1.37 ±0.87 to 2.40 ±1.95 mm (p<0.001). The heart rate (116.2 ±12.25 to 118.50 ±8.20 beats/minute, p=0.18) and systolic BP (114.60 ±17.73 to 118.50 ±12.25 mmHg, p=0.12) did not change significantly on stimulus. The mean fentanyl consumption was 2.4 ug/kg and the side effects were not remarkable. Conclusion Based on our findings, pain has a significant influence on the pupil dilatation reflex in anesthetized children, and opioid administration based on pupil diameter can be valuable in clinical settings. We recommend the use of pupillometry as a pain index in children undergoing surgery under general anesthesia, and it can be a beneficial tool for assessing intraoperative pain. Newer techniques and developments are required in this field.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518524 | PMC |
| http://dx.doi.org/10.7759/cureus.43894 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluating the use of sublingual sufentanil in patients with buprenorphine treatment who are undergoing ambulatory surgery: A Prospective Case Report.
Orthop Rev (Pavia)
December 2024
Anesthesiology Montefiore Medical Center, Albert Einstein College of Medicine.
Introduction: Opioid use disorder is a chronic illness with significant morbidity and mortality. Opioid agonists, like buprenorphine, are commonly used to prevent relapse. Recent changes in buprenorphine legislation are expected to increase prescription and guidelines recommend its continuation during the perioperative period for many patients.
View Article and Find Full Text PDFPredictive Scores for Identifying Chronic Opioid Dependence After General Anesthesia Surgery.
J Pain Res
December 2024
Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China.
Purpose: To address the prevalence and risk factors of postoperative chronic opioid dependence, focusing on the development of a predictive scoring system to identify high-risk populations.
Methods: We analyzed data from the Taiwan Health Insurance Research Database spanning January 2016 to December 2018, encompassing adults undergoing major elective surgeries with general anesthesia. Patient demographics, surgical details, comorbidities, and preoperative medication use were scrutinized.
VACStent closure of oesophageal defects by covered stent and endoscopic vacuum therapy: initial use and clinical outcomes.
J Surg Case Rep
January 2025
Department of Surgery, Mercy University Hospital, Grenville Place, Cork, T12 WE28, Ireland.
Endoscopic management of transmural oesophageal defects following esophagectomy or spontaneous perforations, such as Boerhaave's syndrome, is often complicated by stent migration and luminal occlusion [1]. The Vacuum-Assisted Closure (VAC) stent, which integrates a covered stent with endoscopic vacuum therapy, aims to address these issues by providing functional drainage and promoting wound healing [2]. This case series presents our initial experience with VACStent therapy in four patients treated between February 2023 and April 2024.
View Article and Find Full Text PDFMultidisciplinary consensus-based statement on the current role of middle meningeal artery embolization (MMAE) in chronic SubDural hematoma (cSDH).
Brain Spine
November 2024
ESNR Delegate, Diagnostic and Interventional Neuroradiology, Cardarelli Hospital, Naples, Italy.
Introduction: Middle Meningeal Artery Embolization (MMAE) in patients with chronic SubDural Hematoma (cSDH) is a novel treatment approach, albeit the specific role of MMAE in the treatment of cSDH is not yet defined.
Research Question: The aim of this work is to provide a consensus-based statement from a multidisciplinary panel on the current role of MMAE in patients with cSDH.
Materials And Methods: A literature search was performed using the keywords MMAE and cSDH.
The impact of surgery with general anesthesia on cognitive function and putamen volume: a cross-sectional study among older adults.
Front Aging Neurosci
December 2024
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Previous studies have shown that surgery under general anesthesia may diminish cognitive function; however, the proposed mechanisms need further elucidation. The purpose of the current study was twofold: (1) to compare overall and domain-specific differences in cognitive function between the surgery under general anesthesia group and the control group, and (2) to investigate the possible mechanisms of surgery under general anesthesia affecting cognitive function, using T1-structural magnetic resonance imaging.
Methods: A total of 194 older adults were included in this study.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!