- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT07573150
Pupillometry in Identifying Risk of Postoperative Opioid-induced Respiratory Depression in Children Undergoing Tonsillectomy
Pupillometry in Identifying Postoperative Opioid-induced Respiratory Depression in Children Undergoing Tonsillectomy
This study will evaluate whether quantitative pupillometry measurements can be used to identify children at risk for postoperative opioid-induced respiratory depression (OIRD) following tonsillectomy. Opioid-induced respiratory depression is a serious and potentially life-threatening complication that can occur after surgery, and current monitoring approaches are limited in their ability to predict which patients are at highest risk.
In this prospective observational cohort study, approximately 300 pediatric patients undergoing tonsillectomy will undergo non-invasive pupillometry measurements at defined perioperative time points, including preoperative, intraoperative, and postoperative periods. Pupillometry measurements will be collected using a commercially available, FDA-regulated infrared pupillometer. These measurements will include pupil size, constriction and dilation velocities, and latency in response to light stimulation.
Pupillometry data will be collected for research purposes only and will not be used to guide clinical care or treatment decisions. Standard clinical care will not be altered as part of this study. Clinical outcomes, including the occurrence of postoperative opioid-induced respiratory depression, opioid use, sedation levels, pain scores, and other postoperative events, will be recorded from the medical record.
The goal of this study is to evaluate the relationship between pupillary response patterns and the occurrence of postoperative respiratory depression, and to support the development of predictive models that may improve early identification of patients at risk for opioid-related adverse events.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
This is a prospective, observational cohort study designed to evaluate the relationship between perioperative pupillary responses and postoperative opioid-induced respiratory depression (OIRD) in pediatric patients undergoing tonsillectomy.
Approximately 300 participants aged 3 to less than 18 years will be enrolled across participating clinical sites. Pupillometry measurements will be obtained using a portable, automated infrared pupillometer at predefined perioperative time points, including preoperative baseline, intraoperative periods, and postoperative recovery. Measurements will include resting pupil diameter, pupillary light reflex parameters (including percent constriction, constriction velocity, dilation velocity, and latency), and pupillary unrest in ambient light.
Pupillometry measurements will be collected solely for research purposes and will not be used to guide clinical management. All patients will receive standard perioperative care as determined by the clinical team.
The primary outcome is the occurrence of postoperative opioid-induced respiratory depression, defined as persistent oxygen desaturation (SpO2 <90%) or respiratory rate <8 breaths per minute in the absence of airway obstruction in the post-anesthesia care unit. Secondary outcomes include opioid consumption, sedation scores, pain scores, and postoperative complications such as nausea and vomiting.
Data will be analyzed to assess the association between pupillary response parameters and the occurrence of respiratory depression, and to support development of predictive models for identifying patients at increased risk of opioid-related adverse events.
Tipo de estudio
Inscripción (Estimado)
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Alisha Maslanka, BS, CCRC
- Número de teléfono: 412-491-2748
- Correo electrónico: alisha.maslanka@chp.edu
Copia de seguridad de contactos de estudio
- Nombre: Senthilkumar Sadhasivam, MD
- Número de teléfono: 513-253-4684
- Correo electrónico: sadhasivams@upmc.edu
Ubicaciones de estudio
-
-
California
-
San Francisco, California, Estados Unidos, 94158
- Aún no reclutando
- UCSF Benioff Children's Hospital
-
Contacto:
- Rachel Eshima McKay, MD
- Número de teléfono: 415-310-7722
- Correo electrónico: Rachel.Eshima@ucsf.edu
-
Contacto:
- Travis Rimando, BS
- Número de teléfono: 415-260-8568
- Correo electrónico: Travis.Rimando@ucsf.edu
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, Estados Unidos, 15213
- Reclutamiento
- UPMC Children's Hospital of Pittsburgh
-
Contacto:
- Alisha Maslanka, BS, CCRC
- Número de teléfono: 412-491-2748
- Correo electrónico: alisha.maslanka@chp.edu
-
Contacto:
- Himali Vyas, M.B.B.S
- Número de teléfono: 734.203.9987
- Correo electrónico: vyash3@upmc.edu
-
Investigador principal:
- Mihaela Visoiu, MD
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Niño
Acepta Voluntarios Saludables
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Age 3 to less than 18 years
- Scheduled to undergo tonsillectomy with or without adenoidectomy
- Planned postoperative recovery in a monitored clinical setting (e.g., post-anesthesia care unit)
- Ability to obtain informed consent from parent or legal guardian and assent from the participant when developmentally appropriate
Exclusion Criteria:
- Known neurologic or ophthalmologic conditions that may affect pupillary function
- Use of medications known to significantly alter pupillary response outside of standard perioperative care
- Inability to obtain adequate pupillometry measurements (e.g., due to eye injury or inability to safely perform measurement)
- Patients not receiving opioids as part of perioperative care
- Any condition that, in the opinion of the investigator, would interfere with study participation or data interpretation
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
Intervención / Tratamiento |
|---|---|
|
Pediatric Tonsillectomy Patients
Pediatric participants aged 3 to less than 18 years undergoing tonsillectomy.
Participants will undergo non-invasive pupillometry measurements at predefined perioperative time points.
Pupillometry data are collected for research purposes only and will not be used to guide clinical care.
All participants will receive standard perioperative management as determined by the clinical team.
|
Non-invasive pupillometry measurements will be performed using a commercially available, FDA-regulated infrared pupillometer.
Measurements will be collected at predefined perioperative time points for research purposes only and will not be used to guide clinical care.
Otros nombres:
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Occurrence of Postoperative Opioid-Induced Respiratory Depression
Periodo de tiempo: From arrival in post-anesthesia care unit (PACU) through PACU discharge (up to 4 hours postoperatively)
|
Postoperative opioid-induced respiratory depression is defined as the occurrence of either (1) oxygen saturation (SpO2) <90% for a sustained period, or (2) respiratory rate <8 breaths per minute, in the absence of airway obstruction, during the post-anesthesia care unit stay.
Events will be identified from clinical monitoring data and medical record documentation.
|
From arrival in post-anesthesia care unit (PACU) through PACU discharge (up to 4 hours postoperatively)
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Opioid Consumption
Periodo de tiempo: From induction of anesthesia through transfer to the post-anesthesia care unit (PACU) (up to 2 hours) through PACU discharge (up to 4 hours postoperatively); data collection across these periods may extend up to 6 hours in total.
|
Total opioid dose administered during the intraoperative and immediate postoperative period, recorded from the medical record and normalized to body weight where appropriate.
|
From induction of anesthesia through transfer to the post-anesthesia care unit (PACU) (up to 2 hours) through PACU discharge (up to 4 hours postoperatively); data collection across these periods may extend up to 6 hours in total.
|
|
Sedation Level
Periodo de tiempo: During PACU stay (up to 4 hours postoperatively)
|
Sedation level assessed using clinically documented sedation scales recorded during routine care in the post-anesthesia care unit (PACU), including scales such as the Richmond Agitation-Sedation Scale (RASS; range -5 to +4, where more negative values indicate deeper sedation) or equivalent institution-specific scales.
Higher levels of sedation correspond to lower (more negative) scores.
|
During PACU stay (up to 4 hours postoperatively)
|
|
Pain Scores
Periodo de tiempo: During PACU stay (up to 4 hours postoperatively)
|
Pain intensity scores measured using age-appropriate validated scales (e.g., Numeric Rating Scale or FLACC) as recorded during routine clinical care.
The Numeric Rating Scale (0 to 10, where 0 indicates no pain and 10 indicates worst possible pain) and for the Face, Legs, Activity, Cry, Consolability (FLACC) scale (0 to 10, where higher scores indicate greater pain), as recorded during routine clinical care in the post-anesthesia care unit (PACU).
Scale selection will be based on patient age and clinical appropriateness.
|
During PACU stay (up to 4 hours postoperatively)
|
|
Postoperative Nausea and Vomiting
Periodo de tiempo: During PACU stay (up to 4 hours postoperatively)
|
Occurrence of nausea and/or vomiting documented in the medical record during the PACU stay.
|
During PACU stay (up to 4 hours postoperatively)
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Director de estudio: Jeffrey W Oliver, PhD, NeurOptics Inc
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Manifestaciones neurológicas
- Enfermedades del Sistema Nervioso
- Procesos Patológicos
- Enfermedades de las vías respiratorias
- Manifestaciones neuroconductuales
- Trastornos de la respiración
- Signos y Síntomas Respiratorios
- Trastornos de la percepción
- Condiciones Patológicas, Signos y Síntomas
- Signos y síntomas
- Insuficiencia respiratoria
- Agnosia
- Complicaciones Postoperatorias
- Hipoventilación
Otros números de identificación del estudio
- NIH-OiRD
- R44DA055407 (Subvención/contrato del NIH de EE. UU.)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .