Pupil response to painful stimuli during inhalation anaesthesia without opioids in children

Ji, Sang‐Hwan; Cho, Sung‐Ae; Jang, Young‐Eun; Kim, Eun‐Hee; Lee, Ji‐Hyun; Kim, Jin‐Tae; Kim, Hee-Soo

doi:10.1111/aas.14071

Cited by 2 publications

(5 citation statements)

References 25 publications

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“…In addition, a pupillometer can guide postoperative analgesia 27 . The change of NPi, one of the indicators to evaluate pupil reactivity through pupillary light reflex, was observed in anesthetized pediatric patients with noxious stimulation 21,28 . Furthermore, it has been reported that NPi differed depending on the type of anesthetic in adult patients undergoing general anesthesia 18 .…”

Section: Discussionmentioning

confidence: 99%

“…As assumed in the previous study, this may be because the rapid dilation of the pupil diameter affects the calculation formula of NPi. 21 Since the emergence profiles of sevoflurane and propofol are different in terms of postoperative nausea and vomiting or emergence agitation, further studies are required on the mechanisms underlying the differences in emergence profiles between propofol and volatile anesthetics and their effects on pupillary or midbrain function. The CV and DV were both affected by the type of anesthetic agent used.…”

Section: Discussionmentioning

confidence: 99%

“…However, NPi can be altered under general anesthesia using propofol in adults, even in the absence of neurological deficits 15 . According to our previous study, the NPi value could be affected by the noxious stimuli under sevoflurane anesthesia in pediatric population 21 . Moreover, when compared to the case of maintenance of anesthesia using propofol, the NPi showed a lower value when using inhalational anesthetics in adult patients 18 .…”

Section: Introductionmentioning

confidence: 88%

“…15 According to our previous study, the NPi value could be affected by the noxious stimuli under sevoflurane anesthesia in pediatric population. 21 Moreover, when compared to the case of maintenance of anesthesia using propofol, the NPi showed a lower value when using inhalational anesthetics in adult patients. 18 However, there has been no study comparing NPi when different anesthetic agents were used in pediatric patients.…”

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confidence: 97%

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Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

Kang

Park

et al. 2023

Pediatric Anesthesia

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Background:The light reflex, which reflects central nervous system dysfunction, can also be affected by anesthetic agents. Aims:We evaluated whether these effects differed according to the anesthetic agent in pediatric patients.Methods: Twenty children aged 3-12 years who were scheduled to undergo elective surgery under general anesthesia were randomly allocated to propofol and sevoflurane groups and underwent pupillometric assessments at five points during anesthesia: T1, after confirming loss of consciousness; T2, after endotracheal intubation; T3, at the time of skin incision; T4, 1 h after skin incision; and T5, before endotracheal extubation. The primary outcome was the Neurological Pupil index at T4, and the secondary outcomes were other pupillometric parameters, including pupil diameter, percentage of change in pupil diameter, dilation velocity, and constriction velocity.Results: At T4, the Neurological Pupil index was significantly lower in the sevoflurane group (median difference, 0.30; 95% CI, 0.00 to 0.70; p = .036). Furthermore, the Neurological Pupil index at all time points was lower in the sevoflurane group. The timeand-group interaction effects on constriction velocity and dilation velocity were significantly different [F(1, 4) = 16.68, p = .002; F(1, 4) = 14.78, p = .008, respectively] but were not different on the Neurological Pupil index, pupil diameter, and percentage of change in pupil diameter. No intergroup differences were observed in the baseline characteristics, the flow rate of remifentanil at each time point, and total infused remifentanil. Conclusion:The Neurological Pupil index value in pediatric patients under general anesthesia is affected by the anesthetic agent used; this factor requires consideration in evaluations of the Neurological Pupil index during general anesthesia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

mentioning

confidence: 97%

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Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

Kang

Park

et al. 2023

Pediatric Anesthesia

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“…The effects of pain on pupil size were described already more than a century ago (Bumke, 1911) and have been reported in a variety of populations (Drummond & Clark, 2023;Ji et al, 2022;Macchini et al, 2022;Sillevis et al, 2021;Yılmaz, 2022). Only a few modern-day studies have directly investigated the effects of non-painful tactile stimulation on pupil size, mostly in animals (Gusso et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Pupil dilation reveals the intensity of touch

Ten Brink,

Heiner,

Dijkerman

et al. 2024

Psychophysiology

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Touch is important for many aspects of our daily activities. One of the most important tactile characteristics is its perceived intensity. However, quantifying the intensity of perceived tactile stimulation is not always possible using overt responses. Here, we show that pupil responses can objectively index the intensity of tactile stimulation in the absence of overt participant responses. In Experiment 1 (n = 32), we stimulated three reportedly differentially sensitive body locations (finger, forearm, and calf) with a single tap of a tactor while tracking pupil responses. Tactile stimulation resulted in greater pupil dilation than a baseline without stimulation. Furthermore, pupils dilated more for the more sensitive location (finger) than for the less sensitive location (forearm and calf). In Experiment 2 (n = 20) we extended these findings by manipulating the intensity of the stimulation with three different intensities, here a short vibration, always at the little finger. Again, pupils dilated more when being stimulated at higher intensities as compared to lower intensities. In summary, pupils dilated more for more sensitive parts of the body at constant stimulation intensity and for more intense stimulation at constant location. Taken together, the results show that the intensity of perceived tactile stimulation can be objectively measured with pupil responses – and that such responses are a versatile marker for touch research. Our findings may pave the way for previously impossible objective tests of tactile sensitivity, for example in minimally conscious state patients.

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Pupil response to painful stimuli during inhalation anaesthesia without opioids in children

Cited by 2 publications

References 25 publications

Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

Comparison of effects of volatile and intravenous anesthetics on pupillary function during general anesthesia in children: A prospective observational study

Pupil dilation reveals the intensity of touch

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