Foreseeing postoperative pain in neurosurgical patients: pupillometry predicts postoperative pain ratings—an observational study

Vide, Sérgio; Castro, Ana; Correia, Rui; Cabral, Tiago; Lima, Deolinda; Nunes, Catarina S.; Gambús, Pedro L.; Amorim, Pedro

doi:10.1007/s10877-020-00570-3

Cited by 6 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The predictive models developed by Yoshida et al used both clinical and genetic factors similar to our study, whereas all other studies relied only on clinical factors to develop the respective predictive models. 36 We observed that including genetic and nongenetic factors improved the performance of predictive algorithms when compared with previous studies, indicating that genetic factors play an important role and should be considered in future studies as well. Our study is the first study to develop a dynamic web application for predicting 24-hour postoperative fentanyl requirement, pain scores, and timing of analgesia.…”

Section: Discussionmentioning

confidence: 52%

“…Previous studies reported that pupillary reflex dilation (PRD) and pupillary unrest under ambient light (PUAL) were associated with postoperative pain scores and opioid analgesic efficacy, respectively. 28,36 Patients with longer durations of surgery may have longer periods of recovery in the postoperative period which may explain the higher TFA in such patients. A study by Habib et al 11 also reported that the duration of surgery was significantly associated with opioid analgesic dose in patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictive models for fentanyl dose requirement and postoperative pain using clinical and genetic factors in patients undergoing major breast surgery

Kumar

Ramasamy

Sistla

et al. 2022

Pain

View full text Add to dashboard Cite

Fentanyl exhibits interindividual variability in its dose requirement due to various nongenetic and genetic factors such as single nucleotide polymorphisms (SNPs). This study aims to develop and cross-validate robust predictive models for postoperative fentanyl analgesic requirement and other related outcomes in patients undergoing major breast surgery. Data regarding genotypes of 10 candidate SNPs, cold pain test (CPT) scores, pupillary response to fentanyl (PRF), and other common clinical characteristics were recorded from 257 patients undergoing major breast surgery. Predictive models for 24-hour fentanyl requirement, 24-hour pain scores, and time for first analgesic (TFA) in the postoperative period were developed using 4 different algorithms: generalised linear regression model, linear support vector machine learning (SVM-Linear), random forest (RF), and Bayesian regularised neural network. The variant genotype of OPRM1 (rs1799971) and higher CPT scores were associated with higher 24-hour postoperative fentanyl consumption, whereas higher PRF and history of hypertension were associated with lower fentanyl requirement. The variant allele of COMT (rs4680) and higher CPT scores were associated with 24-hour postoperative pain scores. The variant genotype of CTSG (rs2070697), higher intraoperative fentanyl use, and higher CPT scores were associated with significantly lower TFA. The predictive models for 24-hour postoperative fentanyl requirement, pain scores, and TFA had R-squared values of 0.313 (SVM-Linear), 0.434 (SVM-Linear), and 0.532 (RF), respectively. We have developed and cross-validated predictive models for 24-hour postoperative fentanyl requirement, 24-hour postoperative pain scores, and TFA with satisfactory performance characteristics and incorporated them in a novel web application.

show abstract

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Predictive models for fentanyl dose requirement and postoperative pain using clinical and genetic factors in patients undergoing major breast surgery

Kumar

Ramasamy

Sistla

et al. 2022

Pain

View full text Add to dashboard Cite

show abstract

“…These results in our study are inconsistent with previous research. Vide et al showed that there is a statistically significant correlation between pupillary pain index (PPI) score (an index obtained by calculation from the PRD) before extubation and NRS scores in neurosurgical patients 19 . A study of 20 children also found that the PPI score immediately before tracheal extubation was significantly associated with the LLANTO scale (a Spanish observational pain scale) score 20 .…”

Section: Discussionmentioning

confidence: 99%

The association between perioperative pupillary parameters and postoperative acute pain: A pilot cross‐sectional study

Fang

Tang

et al. 2021

Pain Practice

View full text Add to dashboard Cite

Objective We aim to explore the capacity of perioperative pupillary variables to predict acute pain in the post‐anesthesia care unit (PACU). Methods Patients scheduled to undergo thoracic or abdominal surgery under general anesthesia between April 2021 and June 2021 were enrolled. We measured the pupil diameter, pupillary light reflex (PLR), and pupillary reflex dilatation 5 min before anesthesia induction (T1), 5 min after intubation (T2), at the end of anesthesia (T3), immediately before extubation (T4), and 5 min after extubation (T5). We assessed the early postoperative pain intensity in the PACU using Numeric Rating Scales (NRS) at recovery, 5 min after recovery, and 10 min after recovery. Logistic regression models were used to evaluate the association between perioperative pupillary variables and postoperative pain intensity. Results Fifty‐one patients were enrolled, 50 of whom were included in the final analysis. A total of 13 patients (26%) needed remedial analgesia in the PACU. Pupil parameters at T1, T2, T3, and T5 were not associated with NRS in the PACU. Multiple logistic regression models and receiver operating characteristic (ROC) curves indicated that only latency of PLR at T4 can predict postoperative acute pain. The ROC analysis showed that the cutoff value for latency of PLR at T4 was 0.29 s to discriminate between no pain and pain, and the area under the curve was 0.778 (95% CI 0.634–0.922, p = 0.002) with sensitivity 50.0% and specificity 91.7%. Conclusion The latency of PLR immediately before extubation may be a useful predictor for postoperative acute pain in the PACU.

show abstract

Nozizeptionsmonitoring

Nitzschke

Fischer²,

Funcke³

2021

Anaesthesist

View full text Add to dashboard Cite

Foreseeing postoperative pain in neurosurgical patients: pupillometry predicts postoperative pain ratings—an observational study

Cited by 6 publications

References 28 publications

Predictive models for fentanyl dose requirement and postoperative pain using clinical and genetic factors in patients undergoing major breast surgery

Predictive models for fentanyl dose requirement and postoperative pain using clinical and genetic factors in patients undergoing major breast surgery

The association between perioperative pupillary parameters and postoperative acute pain: A pilot cross‐sectional study

Nozizeptionsmonitoring

Contact Info

Product

Resources

About