Perfusion Index as an Objective Measure for Postoperative Pain Assessment in Pediatric Patients.

Overview

It has been demonstrated that infants and children experience pain in a similar manner to adults, however it used to be undertreated when compared to adult.

Perfusion Index (PI) derived from pulse plethysmography waveform, represents a ratio of pulsatile signal (during arterial inflow) to non-pulsatile signal. PI can represent the peripheral perfusion dynamics due to change of peripheral vasomotor tone. Low PI values suggest peripheral vasoconstriction and high PI values suggest peripheral vasodilation.

The sympathetic nervous system is inherently involved in the pathophysiological responses evoked by painful stimulation.

In the current study, investigators hypothesise that the PI could be a good objective tool for assessment of postoperative pain in children undergoing adenotonsillectomy.

Full Title of Study: “Evaluation of Perfusion Index as an Objective Measure for Postoperative Pain Assessment in Pediatric Patients Undergoing Adenotonsillectomy. An Observational Study.”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Retrospective
  • Study Primary Completion Date: June 2019

Interventions

  • Other: postoperative pain assessment
    • evaluation of the efficacy of PI as an objective measure for postoperative pain assessment in pediatric population undergoing adenotonsillectomy.

Clinical Trial Outcome Measures

Primary Measures

  • Correlation between postoperative (Children’s Hospital of Eastern Ontario Scale ) CHEOPS score and postoperative perfusion index.
    • Time Frame: the time span between arrival to PACU and for at least two hours postoperative

Secondary Measures

  • perioperative mean arterial blood pressure in mmHg
    • Time Frame: time span between preoperative till Two hours postoperative
  • perioperative heart rate as beat/min
    • Time Frame: he time span between arrival to PACU and for at least two hours postoperative
  • CHEOPS score reading in PACU. on arrival and every 15 minutes for two hours and the concomitant PI values with CHEOPS.
    • Time Frame: The time span between arrival to PACU and for at least two hours postoperative
  • Correlate between baseline PI and total postoperative morphine consumption
    • Time Frame: The time span between arrival to PACU and for at least two hours postoperative

Participating in This Clinical Trial

Inclusion Criteria

1. ASA physical status I-II

2. Age 3 to 7 years

3. Children undergoing adenotonsillectomy.

Exclusion Criteria

1. Parents' refusal.

2. Children with behavioral changes

3. Children with physical developmental delay

4. Children on treatment with sedative or anticonvulsant.

Gender Eligibility: All

Minimum Age: 3 Years

Maximum Age: 7 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Cairo University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Abeer Ahmed, MD, Assistant Professor of Anesthesia, SICU & pain management. Kasralainy Faculty of medicine – Cairo University
  • Overall Contact(s)
    • Abeer Ahmed, MD, 01005244590, abeer_ahmed@kasralainy.edu.eg

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