Interest of Instantaneous Fluctuations of Pupillary Diameter for Pain Evaluation in Intensive Care Sedated Patients.

New pain assessment parameter, called the Variation Coefficient of Pupillary Diameter (VCPD) described. This parameter allows evaluating the pain of patients during uterine contractions in obstetrical labor, and postoperatively in recovery room.This parameter also allows evaluating the level of pain in Intensive Care Unit (ICU), in intubated or tracheotomized patients moderately sedated (Riker score 3 or 4).

Inclusion Criteria:hospitalized in the surgical Intensive Care Unit (ICU) of the University Hospital of Saint-Etienne between September 2015 and August 2016 for medical-surgical pathologiesrequiring orotracheal intubation or tracheostomyand presenting a Riker sedation score of 3 or 4.Exclusion Criteria:cerebral palsycurarizationparaplegia or tetraplegiaintensive care neuromyopathyocular pathologyhistory of severe dysautonomic disease that could influence the evaluation of the Behavioral Pain Scale (BPS) or Variation Coefficient of Pupillary Diameter (VCPD) scorereceiving antiarrhythmic treatment that could make the interpretation of the results difficulton metoclopramide, droperidol, clonidine, or dexmedetomidine, which are known to alter the pupil dilation reflex.