Assessment of Pain During Labor with Pupillometry

• DOI: 10.1213/ane.0b013e31828a7218
• Publication Date: 2013-03-12T12:30:41Z
• Authors: Jean Guglielminotti; France Mentré; Johann Gaillard; Mohamed Ghalayini; Philippe Montravers; Dan Longrois
• Keywords: Pupillometry; Stimulus (psychology); Labor pain; Pupillary reflex

In Brief BACKGROUND: Pain intensity is usually self-rated by patients with a numeric rating scale (NRS) but this cannot be used for noncommunicating patients. anesthetized patients, experimental noxious stimulus increases pupillary diameter (PD) and light reflex amplitude (PLRA), the difference between PD before after stimulation. Labor pain an intense acute nonexperimental stimulus, effectively relieved epidural analgesia. prospective observational study, we therefore describe effects of labor relief analgesia on PLRA, determine their association ability single measurement or PLRA to assess pain. METHODS: first stage, (11-point NRS), PD, were measured in 4 conditions 26 laboring women: presence absence uterine contraction. Pupillometry values among compared, strength absolute changes brought about contraction was assessed r2. second 1 performed 104 women. The discriminate (NRS > 4) also assessed. RESULTS: statistically significant increase pain, observed during contraction, change abolished r2 (r2 = 0.25 [95% confidence interval, 0.07–0.46] 0.34 [0.14–0.56]) higher than 0.14 [0.04–0.28]) 0.22 [0.10–0.37]) suggesting stronger values. 0.23 [0.10–0.38] 0.26 [0.11–0.40] area under receiver operating characteristics curve 0.82 [0.73–0.91] 0.80 [0.71–0.89], respectively. CONCLUSIONS: Changes may as tool Published ahead print March 11, 2013