Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
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.
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.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Interactive | Other | Subject will be asked to continually interactive with the investigators, answering a series of standard questions during the remifentanil infusion and recovery periods. |
|
| Non-interactive | Other | All verbal interaction will be avoided and extraneous sounds will be eliminated from the environment during the remifentanil infusion and recovery periods. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Continuous conversational interaction | Behavioral | Maintaining continuous conversation, requiring that the subject answer questions and engage in discussion without interruption. |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of environmental stimulation on decline in oxygen saturation to ≤ 90%. | Conversational interaction and oxygen saturation measured by pulse oximeter. | 35 minutes |
| Impact of environmental stimulation on CO2 increase of 15% or more above baseline. | Conversational interaction and CO2 measured by transcutaneous sensor. | 35 minutes |
| Correlation between estimated opioid concentration and deviation in pupillary measurement. | Relationship of opioid concentration to pupillary unrest, measured by the pupillometer | 35 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of environmental stimulation on opioid-related deviations in pupillary measurements. | Impact of conversational interaction on degree of decline in pupillary unrest as measured by the pupillometer. | 35 minutes |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Rachel Eshima McKay, M.D. | Professor of Anesthesia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California San Francisco | San Francisco | California | 94143 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33651243 | Derived | 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. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Each subject is his/her own control.
Not provided
Not provided
Not provided
Not provided
|
| Remifentanil infusion | Drug | 10 minute remifentanil infusion |
|
| ID | Term |
|---|---|
| D059787 | Acute Pain |
| D000083682 | Opiate Overdose |
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D062787 | Drug Overdose |
| D063487 | Prescription Drug Misuse |
| D000076064 | Drug Misuse |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D009293 | Opioid-Related Disorders |
| D000079524 | Narcotic-Related Disorders |
| D001523 | Mental Disorders |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
Not provided
Not provided