Trial reportAnesthesia and analgesia2013
Assessment of pain during labor with pupillometry: a prospective observational study.
Trial report in Anesthesia and analgesia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Tell me what to expect: how instructions affect the pain response of patients with chronic myofascial pain with referral.Journal of oral & facial pain and headache · 2024Article
- The value of pupillary diameter in evaluating pain perception after awakening in patients undergoing general anesthesia during orthopedic surgery.BMC anesthesiology · 2024Article
- Assessment of the nociceptive response to the use of cannabidiol alone and in combination with meloxicam through infrared pupillometry in female dogs undergoing elective ovariohysterectomy.Frontiers in veterinary science · 2024Article
- Application of Pupillometry in Neurocritical Patients.Journal of personalized medicine · 2023Review
- Comparative evaluation of visual analogue scale and pupillary diameter for post-operative pain: An observational study.Indian journal of anaesthesia · 2023Article
- Pain sensing neurons promote tissue regeneration in adult mice.NPJ Regenerative medicine · 2021Article
- Self-reported pain scores as a predictor of preterm birth in symptomatic twin pregnancy: a retrospective study.BMC pregnancy and childbirth · 2021Article
- Pupillometry in perioperative medicine: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Review
- Automated Pupillometry in Neurocritical Care: Research and Practice.Current neurology and neuroscience reports · 2019Review
- Assessing pain in the postoperative period: Analgesia Nociception IndexBritish journal of anaesthesia · 2019Article
- A test of positive suggestions about side effects as a way of enhancing the analgesic response to NSAIDs.PloS one · 2019Article
- Habituation of phase-locked local field potentials and gamma-band oscillations recorded from the human insula.Scientific reports · 2018Article
- Infrared pupillometry helps to detect and predict delirium in the post-anesthesia care unit.Journal of clinical monitoring and computing · 2018Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPain intensity is usually self-rated by patients with a numeric rating scale (NRS) but this scale cannot be used for noncommunicating patients. In anesthetized patients, experimental noxious stimulus increases pupillary diameter (PD) and pupillary light reflex amplitude (PLRA), the difference between PD before and after light stimulation. Labor pain is an intense acute nonexperimental stimulus, effectively relieved by epidural analgesia. In this prospective observational study, we therefore describe the effects of labor pain and pain relief with epidural analgesia on PD and PLRA, determine their association with pain intensity and determine the ability of a single measurement of PD or PLRA to assess pain.
methodsIn the first stage, pain (11-point NRS), PD, and PLRA were measured in 4 conditions in 26 laboring women: before and after epidural analgesia and in the presence and absence of a uterine contraction. Pupillometry values among the 4 conditions were compared, and the strength of the association between absolute values of pain and PD or PLRA and between pain and changes in PD or PLRA brought about by uterine contraction was assessed with r(2). In the second stage, 1 measurement was performed in 104 laboring women. The strength of the association between pain and PD or PLRA was assessed with r(2). The ability of PD or PLRA to discriminate pain (NRS > 4) was also assessed.
resultsIn the first stage, a statistically significant increase in pain, PD, and PLRA was observed during a contraction, and this change was abolished after epidural analgesia. The r(2) for the association between pain and changes in PD (r(2) = 0.25 [95% confidence interval, 0.07-0.46] or PLRA (r(2) = 0.34 [0.14-0.56]) brought about by a uterine contraction was higher than the r(2) for the association between pain and absolute values of PD (r(2) = 0.14 [0.04-0.28]) or PLRA (r(2) = 0.22 [0.10-0.37]) suggesting a stronger association for changes than for absolute values. In the second stage, r(2) was 0.23 [0.10-0.38] for PD and 0.26 [0.11-0.40] for PLRA and the area under the receiver operating characteristics curve was 0.82 [0.73-0.91] and 0.80 [0.71-0.89], respectively.
conclusionsChanges in PD and PLRA brought about by a uterine contraction may be used as a tool to assess analgesia in noncommunicating patients.
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