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

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Title: The association between perioperative pupillary parameters and postoperative acute pain: A pilot cross‐sectional study.
Authors: Fang, Pan‐pan, Wu, Jun‐qi, Tang, Li‐li, Gao, Shan, Liu, Xue‐Sheng
Source: Pain Practice. Mar2022, Vol. 22 Issue 3, p322-328. 7p. 1 Diagram, 3 Charts, 1 Graph.
Subjects: Abdominal surgery, Pain measurement, Confidence intervals, Recovery rooms, Multiple regression analysis, Pupil (Eye), Surgery, Patients, Chest injuries, Treatment effectiveness, Sensitivity & specificity (Statistics), Postoperative pain
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The association between perioperative pupillary parameters and postoperative acute pain: A pilot cross‐sectional study.
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  Data: <searchLink fieldCode="AR" term="%22Fang%2C+Pan‐pan%22">Fang, Pan‐pan</searchLink><br /><searchLink fieldCode="AR" term="%22Wu%2C+Jun‐qi%22">Wu, Jun‐qi</searchLink><br /><searchLink fieldCode="AR" term="%22Tang%2C+Li‐li%22">Tang, Li‐li</searchLink><br /><searchLink fieldCode="AR" term="%22Gao%2C+Shan%22">Gao, Shan</searchLink><br /><searchLink fieldCode="AR" term="%22Liu%2C+Xue‐Sheng%22">Liu, Xue‐Sheng</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Mar2022, Vol. 22 Issue 3, p322-328. 7p. 1 Diagram, 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Abdominal+surgery%22">Abdominal surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+measurement%22">Pain measurement</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Recovery+rooms%22">Recovery rooms</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+regression+analysis%22">Multiple regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Pupil+%28Eye%29%22">Pupil (Eye)</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Chest+injuries%22">Chest injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Sensitivity+%26+specificity+%28Statistics%29%22">Sensitivity & specificity (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Postoperative+pain%22">Postoperative pain</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: 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. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1111/papr.13084
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 7
        StartPage: 322
    Subjects:
      – SubjectFull: Abdominal surgery
        Type: general
      – SubjectFull: Pain measurement
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Recovery rooms
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Pupil (Eye)
        Type: general
      – SubjectFull: Surgery
        Type: general
      – SubjectFull: Patients
        Type: general
      – SubjectFull: Chest injuries
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Sensitivity & specificity (Statistics)
        Type: general
      – SubjectFull: Postoperative pain
        Type: general
    Titles:
      – TitleFull: The association between perioperative pupillary parameters and postoperative acute pain: A pilot cross‐sectional study.
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            NameFull: Fang, Pan‐pan
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            NameFull: Wu, Jun‐qi
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            – D: 01
              M: 03
              Text: Mar2022
              Type: published
              Y: 2022
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