Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study
| العنوان: | Evaluation of Nociception Using Quantitative Pupillometry and Skin Conductance in Critically Ill Unconscious Patients: A Pilot Study |
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| المؤلفون: | Chiara Prezioso, Jean-François Payen, Marta Talamonti, Marco Menozzi, Fabio Silvio Taccone, Lucas Akira Costa Hirai, Francisco A. Lobo, Lorenzo Peluso, Sara Fratino, Jacques Creteur |
| المصدر: | Brain Sciences Volume 11 Issue 1 Brain Sciences, Vol 11, Iss 109, p 109 (2021) |
| بيانات النشر: | Multidisciplinary Digital Publishing Institute, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | automated pupillometer, Schmidt sting pain index, critically illness, Article, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, skin conductance, 030202 anesthesiology, Pain assessment, Pupillary response, Noxious stimulus, Medicine, pain, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, algesimeter, business.industry, General Neuroscience, Glasgow Coma Scale, 030208 emergency & critical care medicine, analgesia, brain injury, Nociception, Pupillary reflex, Anesthesia, business, Pupillometry |
| الوصف: | Background: Pain assessment is a challenge in critically ill patients, in particular those who are unable to express movements in reaction to noxious stimuli. The purpose of the study was to compare the pupillary response and skin conductance to pain stimulation in critically ill unconscious patients. Methods: This observational study included adult patients admitted to the intensive care unit (ICU) with acute brain injury (Glasgow Coma Scale < 9 with a motor response < 5) and/or requirements for deep level of sedation. Automated pupillometry (Algiscan, ID-MED, Marseille, France) was used to determine pupillary reflex dilation during tetanic stimulation. The maximum intensity of the stimulation value allowed the determination of a pupillary pain index score ranging from 1 (no nociception) to 9 (high nociception): a pupillary pain index (PPI) score of &le 4 was used to reflect adequate pain control. For skin conductance (SC), the number of SC peaks per second (NSCF) was collected concomitantly to tetanic stimulation. An NSCF of &le 0.07 peak/second was used to reflect adequate pain control. Results: Of the 51 included patients, there were 32 with brain injury and 19 receiving deep sedation. Mean PPI score was 5 (Interquartile Range= 2&ndash 7) a total of 28 (55%) patients showed inadequate control of the nociceptive stimulation according to the PPI assessment. Only 15 (29%) patients showed a detectable skin conductance, with NSCF values from 0.07 to 0.47/s. No correlation was found between skin conductance algesimeter (SCA)-derived variables and PPI score or pupillary dilation to pain. Conclusions: Detection of inadequate pain control might vary according to the method used to assess nociception in ICU patients. A poor agreement between quantitative pupillometry and skin conductance was observed. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2076-3425 |
| DOI: | 10.3390/brainsci11010109 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6230309ee0c13ebe3aa2d176c0db12db |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....6230309ee0c13ebe3aa2d176c0db12db |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20763425 |
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| DOI: | 10.3390/brainsci11010109 |