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Investigating pupillometry to detect preoperative anxiety: a pilot study.

Jason Richez1, Pierre-Raphaël Rothschild2, Christophe Baillard1

  • 1Department of Anaesthesia and Intensive Care, Hopital Cochin, Assistance Publique-Hopitaux de Paris, Paris, France.

Frontiers in Psychology
|January 19, 2024
PubMed
Summary

This study investigated pupillometry as an objective tool for assessing preoperative anxiety in surgery patients. Researchers found no significant correlation between pupillometry measurements and anxiety levels, suggesting further research is needed.

Keywords:
cataract surgerycoefficient of variationobjective assessmentpre-operative anxietypupillometry

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Area of Science:

  • Anesthesiology
  • Ophthalmology
  • Neuroscience

Background:

  • Preoperative anxiety management is crucial per European Society of Anesthesia guidelines.
  • Current anxiety assessment methods (questionnaires) are lengthy and subjective.
  • Pupillometry offers a potential objective and reproducible method to assess the sympathetic and parasympathetic nervous system balance.

Purpose of the Study:

  • To evaluate the correlation between pupillometry and preoperative anxiety levels in ambulatory ophthalmological surgery patients.
  • To determine if pupillometry can serve as an objective assessment tool for surgical fear.

Main Methods:

  • A prospective observational study involving 71 ambulatory ophthalmological surgery patients.
  • Preoperative anxiety assessed using the Surgical Fear Questionnaire (SFQ).
  • Pupillometry measurements (pupillary diameter variation) taken using an Algiscan® pupillometer before, during, and after IV catheter insertion.

Main Results:

  • No significant statistical correlation was found between baseline pupillary diameter or its variation (VCPD) and preoperative anxiety levels (SFQ scores).
  • Pupillometric variables did not significantly differ based on anxiety levels during or after painful stimulation (cannulation).
  • Median SFQ score was 23 [IQR 11-34].

Conclusions:

  • Current pupillometry techniques, as applied in this study, do not appear to be a reliable objective measure for preoperative anxiety in this patient population.
  • Further research is required to explore the potential of pupillometry in assessing preoperative anxiety and its correlation with autonomic nervous system activity.