Pupillometry to Guide Postoperative Analgesia
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Implication
Clinical evaluation reveals pupillary dilation responses correlate with morphine requirements in postoperative patients, suggesting pupillometry can objectively guide analgesia.
Key Points
- Synthesize evidence on using pupillary dilation responses to standardized noxious stimuli as an objective measure of postoperative nociception to guide opioid administration.
- Evaluated pupillary dilation response (PDR) using an infrared pupillometer during calibrated pressure application on surgical wounds in postanesthesia care unit patients.
- Assessed correlations between PDR magnitude, subjective verbal pain scores, and subsequent morphine requirements.
- PDR magnitude demonstrated a direct relationship with both verbal pain assessments and postoperative morphine requirements following wound pressure stimulation.
- Pupillary dilation to noxious stimuli averaged less than 1 mm over 10 seconds, necessitating infrared pupillometry rather than visual bedside observation.
- Baseline opioid-induced miosis did not eliminate transient pupillary dilation responses to acute noxious stimuli in patients experiencing pain.
Cite This Study
Larson et al. (2012) studied this question.