Pupillary Dilation Reflex Assessment for Intraoperative Analgesic Titration. (PUP-AIT)
Pain, Acute, Anesthesia
About this trial
This is an interventional treatment trial for Pain, Acute focused on measuring pupillary reflex, nociception, heart rate, intraoperative monitoring
Eligibility Criteria
Inclusion Criteria:
- > 18 jaar
- Elective abdominal or gynaecological operation
- ASA (American Society of Anesthesiologists classification): I - II - III
Exclusion Criteria:
- History of invasive ophthalmological surgery
- Known bilateral eye disease
- Known optical of oculomotor nerve deficit
- Active psychiatrical disease
- Proven active pheochromocytoma
- Opioid usage > 7 days preoperative
- Ongoing oncological treatment with chemotherapeutic agents
- Usage of A-1 adrenergic of beta-blocking agents
- Preoperative usage of benzodiazepines
- Topical atropine or phenylephrine (eye droplets)
- Planned perioperative usage of dopamine antagonists
Sites / Locations
- University hospital Antwerp
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Experimental
Active Comparator
Intervention 1
Intervention 2
Intervention 3
Intervention 4
Pupillary dilation reflex based perioperative intravenous remifentanil administration. Starting dose 5 ng/ml by continous infusion, dosage adjustments are made after pupillary dilation reflex assessment every 10 minutes. When PPI score is 1, the dosage is decreased with 0.2 ng/ml. When PPI score is greater than 1, the dosage is increased with 0.2 ng/ml.
Anesthesiologist based perioperative intravenous remifentanil administration (daily practice, standard of care). Starting dose 5 ng/ml, dosage adjustments are made when deemed necessary by attending anesthesiologist.
Pupillary dilation reflex based perioperative intravenous sufentanil administration. Starting dose 0.1 mcg/kg bolus, dosage adjustments are made after pupillary dilation reflex assessment every 10 minutes. When PPI score is 1, no supplementary administration is executed. When PPI score is greater than 1, a supplementary bolus of 0.1 mcg/kg is given.
Anesthesiologist based perioperative intravenous sufentanil administration (daily practice, standard of care). Starting dose 0.1 mcg/kg bolus, dosage adjustments are made when deemed necessary by attending anesthesiologist.