Use of Pupillometry for Pain Assessment in ICU Patients With Delirium

Study Overview
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Brief Summary
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Pain assessment in intensive care patients is a constant challenge. Approximately 50% to 80% of patients report pain at rest or during medical or nursing interventions (for example endotracheal suctioning, mobilization and rehabilitation, presence and care of invasive inputs, etc.). Obstacles to pain assessment and management are most often due to interference with communication due to impaired consciousness, airway support and connection to artificial pulmonary ventilation, or the effect of administered medication. Patients in intensive care are prone to delirium. Delirium can compromise patients' ability to verbalise pain for a variety of reasons (e.g. due to impaired attention, memory, thinking and language barriers). Also, pain and inadequate analgesia are risk factors for delirium. Pupillary reflex changes and their identification by automated pupillometry have yielded positive results regarding nociception assessment in adult and pediatric patients and in perioperative and postoperative care. At the same time, the response of these patients to opioid administration was investigated. The aim was to improve their analgesia. The aim of this study is to find out whether, there is an association between automated pupillometry and selected objective pain measurement scales in The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) positive patients after surgery.

Detailed Description
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Periodically after 6 hours, the incidence of delirium will be assessed using the CAM ICU questionnaire. Subsequently, the incidence of pain will be assessed using 3 valid scales. The Visual Analogue Scale (VAS), the Behavioral Pain Scale (BPS) and the Critical Care Observational Tool (CPOT) will be used. Finally, automated pupillometry will be measured. The measurement values will be entered in the record sheet. Information about the medications administered and the patient's vital signs will also be recorded.

Official Title
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Use of Automated Pupillometry for Pain Assessment in ICU Patients With Delirium

Conditions
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Delirium, Pain, Postoperative

Intervention / Treatment
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* Device: automated pupillometry
* Diagnostic Test: questionnaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient after surgery possibility to perform CAM - ICU test (patients with Richmond Agitation-Sedation Scale -2 to +2) Exclusion Criteria: eye diseases brain injury stroke epilepsy neuromuscular diseases

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| surgical ICU patients<br>All surgical patients on the inpatient ward in the Department of Anesthesiology and Intensive Care | Device: automated pupillometry<br>* Automated pupillometry every 6 hours<br>Diagnostic Test: questionnaire<br>* CAM ICU questionnaire will be used for delirium screening the incidence of pain will be assessed using 3 valid scales. The Visual Analogue Scale (VAS), the Behavioral Pain Scale (BPS) and the Critical Care Observational Tool (CPOT) will be used. questionnaires will be done the same time as pupillometry<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pupillometry parameters and objective pain scales | correlation of pupillometry parameters and objective pain scales | up to 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain, pupillometry, delirium