Pupillometry-guided Remifentanil Infusion Versus Conventional Administration in Children

NCT ID: NCT03749811

Last Updated: 2019-03-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-04

Study Completion Date

2021-11-18

Brief Summary

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Our study aims to compare the total intravenous dose of remifentanil per anesthesia hour and body weight in two groups of pediatric surgical patients - an interventional group with remifentanil infusion under pupillometry monitoring, and control group without pupillometry - to figure out whether pupillometry monitoring may reduce remifentanil consumption during anesthesia while providing sufficient analgesia for surgical noxious stimuli.

Detailed Description

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comparison of total used opioid

Conditions

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Opioid Use

Keywords

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Pupil dilatory reflex Remifentanil Analgesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Interventional group: remifentanil infusion under pupillometry monitoring. Control group: remifentanil infusion without pupillometry monitoring (remifentanil dose is determined by conventional method, i. e., hemodynamic change probably related to noxious stimuli)
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participant does not know in which of the groups he/she is allocated. Only a care provider (an attending anesthesiologist who is responsible for the patient's anesthesia) knows the group which the patient belongs to.

Investigator and outcomes assessor does not know in which of the groups the patient is allocated, since the group name will be just recorded as "A" or "B" until data analysis of the last participant is done.

Study Groups

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Pupillometry group

A group of participants who receive remifentanil infusion under pupillometry monitoring.

Group Type EXPERIMENTAL

Pupillometry

Intervention Type DEVICE

After induction of anesthesia and determination of the loss of consciousness of the participant, baseline diameter of pupil is measured by electronic pupillometry device. During anesthesia, participant's pupil diameter is repeatedly measured with 5-minute interval. Pupil dilation of 30% or more compared to baseline is indicative of insufficient analgesia.

Conventional group

A group of participants who receive remifentanil infusion without pupillometry monitoring; their analgesic dose is mainly determined via hemodyamic change.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Pupillometry

After induction of anesthesia and determination of the loss of consciousness of the participant, baseline diameter of pupil is measured by electronic pupillometry device. During anesthesia, participant's pupil diameter is repeatedly measured with 5-minute interval. Pupil dilation of 30% or more compared to baseline is indicative of insufficient analgesia.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients who are at 3 to 6 years of age, scheduled to undergo elective surgery with estimated time of operation 2 hours or longer, under general anesthesia
* American Society of Anesthesiologists physical status classification (ASA class) I - II
* Patient and his/her parents are willing to participate after explanation of the purpose, materials, methods, possible risks and benefits of the research

Exclusion Criteria

* History of hypersensitivity/allergic reaction to the drugs which are used in general anesthesia
* Preoperative use of analgesics, antipsychotics and/or antiepileptics
* Mental retardation
* Medications related to hindrance of autonomic nerve system activity, e. g., beta blockers
* Underlying ophthalmic diseases
Minimum Eligible Age

3 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hee-Soo Kim

princial investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hee-Soo Kim, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Dept. of Anesthesiology and Pain Medicine, Seoul National University Hospital

Locations

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Seoul National University Hospital

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Hee-Soo Kim, M.D., Ph.D.

Role: CONTACT

Phone: +82-2-2072-3664

Email: [email protected]

Sang-Whan Ji

Role: CONTACT

Phone: +82-2-2072-3661

Email: [email protected]

Facility Contacts

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Heesoo Kim

Role: primary

References

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Wildemeersch D, Peeters N, Saldien V, Vercauteren M, Hans G. Pain assessment by pupil dilation reflex in response to noxious stimulation in anaesthetized adults. Acta Anaesthesiol Scand. 2018 Sep;62(8):1050-1056. doi: 10.1111/aas.13129. Epub 2018 Apr 19.

Reference Type RESULT
PMID: 29671874 (View on PubMed)

Sabourdin N, Barrois J, Louvet N, Rigouzzo A, Guye ML, Dadure C, Constant I. Pupillometry-guided Intraoperative Remifentanil Administration versus Standard Practice Influences Opioid Use: A Randomized Study. Anesthesiology. 2017 Aug;127(2):284-292. doi: 10.1097/ALN.0000000000001705.

Reference Type RESULT
PMID: 28719527 (View on PubMed)

Other Identifiers

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1811-036-984

Identifier Type: -

Identifier Source: org_study_id