Pupillary Unrest in Ambient Light, and Relationship to Opioid-Induced Respiratory Depression

NCT ID: NCT04301895

Last Updated: 2020-03-10

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

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-30

Study Completion Date

2019-09-03

Brief Summary

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Volunteers will receive a weight-based opioid (remifentanil) infusion for 10 minutes. In the first run, serial pupillary measurements (pupillary unrest, pupil diameter) will be taken at baseline, and at 2.5-minute intervals during the infusion and a 25-minute recovery period afterwards. After a washout period, the experiment will be repeated in each subject (second run). The two runs differ only by presence versus absence of verbal interaction.

Detailed Description

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Healthy volunteers aged 20-55 will receive a weight-based opioid (remifentanil) infusion for 10 minutes. Vital signs including SpO2, transcutaneous CO2, and respiratory rate will be continuously measured.

In the first run, serial pupillary measurements (pupillary unrest, pupil diameter) will be taken at baseline, and at 2.5-minute intervals during the infusion and a 25-minute recovery period afterwards. After a washout period, the experiment will be repeated in each subject (second run). The two runs differ only by presence of ongoing verbal interaction versus complete avoidance of verbal interaction.

Incidence of respiratory depression will be compared in the two protocols with or without verbal interaction. Correlation between pupil diameter and pupillary unrest with estimated opioid concentrations will be determined by regression. Difference between pupil measurement versus opioid concentration regressions will be compared by chi2.

Conditions

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Opioid; Intoxication, Perception Disturbance (Acute) Acute Pain Overdose of Opiate Respiratory Depression Safety Issues

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Each subject is his/her own control.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Interactive

Subject will be asked to continually interactive with the investigators, answering a series of standard questions during the remifentanil infusion and recovery periods.

Group Type OTHER

Continuous conversational interaction

Intervention Type BEHAVIORAL

Maintaining continuous conversation, requiring that the subject answer questions and engage in discussion without interruption.

Remifentanil infusion

Intervention Type DRUG

10 minute remifentanil infusion

Non-interactive

All verbal interaction will be avoided and extraneous sounds will be eliminated from the environment during the remifentanil infusion and recovery periods.

Group Type OTHER

Remifentanil infusion

Intervention Type DRUG

10 minute remifentanil infusion

Interventions

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Continuous conversational interaction

Maintaining continuous conversation, requiring that the subject answer questions and engage in discussion without interruption.

Intervention Type BEHAVIORAL

Remifentanil infusion

10 minute remifentanil infusion

Intervention Type DRUG

Other Intervention Names

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Environmental stimulation

Eligibility Criteria

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Inclusion Criteria

* Healthy
* Able to provide informed consent

Exclusion Criteria

* Active substance use disorder
* Prior opioid use disorder
* Opioid use within 30 days.
Minimum Eligible Age

20 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rachel Eshima McKay, M.D.

Role: PRINCIPAL_INVESTIGATOR

Professor of Anesthesia

Locations

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University of California San Francisco

San Francisco, California, United States

Site Status

Countries

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United States

References

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McKay RE, Kohn MA, Larson MD. Pupillary unrest, opioid intensity, and the impact of environmental stimulation on respiratory depression. J Clin Monit Comput. 2022 Apr;36(2):473-482. doi: 10.1007/s10877-021-00675-3. Epub 2021 Mar 2.

Reference Type DERIVED
PMID: 33651243 (View on PubMed)

Other Identifiers

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221163

Identifier Type: -

Identifier Source: org_study_id

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