TY - JOUR T1 - The use of pupillometry as monitoring of intraoperative analgesia in the consumption of analgesics during the first 12hours after surgery JO - Revista Española de Anestesiología y Reanimación (English Edition) T2 - AU - Abad Torrent,A. AU - Rodríguez Bustamante,V. AU - Carrasco Fons,N. AU - Roca Tutusaus,F.J. AU - Blanco Vargas,D. AU - González García,C. SN - 23411929 M3 - 10.1016/j.redare.2015.12.003 DO - 10.1016/j.redare.2015.12.003 UR - https://www.elsevier.es/en-revista-revista-espanola-anestesiologia-reanimacion-english-444-articulo-the-use-pupillometry-as-monitoring-S2341192915001067 AB - IntroductionIntraoperative evaluation of analgesia remains today often based on heart rate and arterial pressure fluctuations. None of these parameters are specific. Incorrect handling during this process may increase surgical morbi-mortality of the patients and their acute postoperative pain. The aim of this study was to evaluate the impact of intraoperative analgesia controlled by pupillometry on postoperative analgesic consumption and the pain intensity in the first 12h in the hospital room, after major gynaecological surgery. Patients and methodsA prospective, cohort study with allocation of groups sequentially according to the programming of the operating room was designed. ASA I–III patients scheduled for elective surgery of abdominal hysterectomy by laparotomy or laparoscopy through intravenous general anaesthesia were included. Patients were divided into 2 groups: pupillometry group (P-1), in which intraoperative analgesia was guided by pupillometry, and haemodynamic group (H-2), according to values of blood pressure and heart rate. In the hospitalisation room, the values of visual analogue scale (VAS) were routinely registered with 3 courts for the study: 3, 8 and 12h of the postoperative period. Postoperative analgesia was standardised as follows: NSAIDs was administered if VAS was ≥3 or if the patient expressly requested an analgesic. After this, the efficacy of treatment was assessed. If the patient had pain, the next scheduled drug was given up to an VAS<3. Data for total analgesic consumption administered in the hospital room, VAS and adverse effects were collected within 12h postoperatively. ResultsA total of 59 patients, 30 group P-1 and 29 group H-2, were included. Group P-1 experienced less pain than group H-2, with statistical significance in each phase (VAS 3h, VAS 8h and VAS 12h). These data are consistent with the consumption of analgesics for patients. There was a statistically significant reduction (p<0.001) in the group P-1 (1.80 [DE 0.99]; medium 2, 95% confidence interval 1.43–2.17) compared with group H-2 (5.66 [1.58]; medium 6, 95% confidence interval 5.05–6.26). ConclusionsMonitoring of the intraoperative analgesia by pupillometry was able to reduce the intensity of the acute postoperative pain and analgesic consumption in the first 12h in the hospital room after major gynaecological surgery. ER -