ArticleBrain sciences2021
Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study.
Article in Brain sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 18 citations in OpenAlex.
- The Meaning of Pain in the Clinical Management of Patients With Disorders of Consciousness: Is It a Neglected Issue?European journal of pain (London, England) · 2026Review
- Pupillometry as a Novel Tool for Pain Monitoring: Evaluating the Antinociceptive Effect of Intravenous Lidocaine During Orotracheal Intubation.Journal of clinical medicine · 2026Article
- Automated pupillometry for detection of delirium in surgical intensive care patients.Frontiers in medicine · 2026Article
- Challenges of the Regional Anesthetic Techniques in Intensive Care Units - A Narrative Review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Review
- Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool.International journal of nursing sciences · 2024Article
- Can Opioid-Free Anaesthesia Be Personalised? A Narrative Review.Journal of personalized medicine · 2023Review
- Adequacy of Anesthesia Guidance for Colonoscopy Procedures.Pharmaceuticals (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPain assessment is a challenge in critically ill patients, in particular those who are unable to express movements in reaction to noxious stimuli. The purpose of the study was to compare the pupillary response and skin conductance to pain stimulation in critically ill unconscious patients.
methodsThis observational study included adult patients admitted to the intensive care unit (ICU) with acute brain injury (Glasgow Coma Scale < 9 with a motor response < 5) and/or requirements for deep level of sedation. Automated pupillometry (Algiscan, ID-MED, Marseille, France) was used to determine pupillary reflex dilation during tetanic stimulation. The maximum intensity of the stimulation value allowed the determination of a pupillary pain index score ranging from 1 (no nociception) to 9 (high nociception): a pupillary pain index (PPI) score of ≤4 was used to reflect adequate pain control. For skin conductance (SC), the number of SC peaks per second (NSCF) was collected concomitantly to tetanic stimulation. An NSCF of ≤0.07 peak/second was used to reflect adequate pain control.
resultsOf the 51 included patients, there were 32 with brain injury and 19 receiving deep sedation. Mean PPI score was 5 (Interquartile Range= 2-7); a total of 28 (55%) patients showed inadequate control of the nociceptive stimulation according to the PPI assessment. Only 15 (29%) patients showed a detectable skin conductance, with NSCF values from 0.07 to 0.47/s. No correlation was found between skin conductance algesimeter (SCA)-derived variables and PPI score or pupillary dilation to pain.
conclusionsDetection of inadequate pain control might vary according to the method used to assess nociception in ICU patients. A poor agreement between quantitative pupillometry and skin conductance was observed.
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