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Related Experiment Video

Updated: Jan 7, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Pupillary Reaction to Opioids on Awake Subjects: A Systematic Review.

Luiza Palmieri Serrano1, Sahar Borna1, Karla C Maita1

  • 1Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL.

Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses
|January 3, 2026
PubMed
Summary

Pupillometry shows potential for objectively measuring opioid effects and pain response. This tool, when used with other vital signs, can improve pain assessment and opioid safety, but requires consideration of individual patient factors.

Keywords:
AnalgesicsOpioidPainPupil

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Area of Science:

  • Pain Management
  • Pharmacology
  • Ophthalmology

Background:

  • Subjective pain reporting can be unreliable in certain patient populations.
  • Objective pain assessment tools are needed to complement traditional methods.
  • Opioid analgesics significantly impact physiological parameters, including pupillary response.

Purpose of the Study:

  • To evaluate the correlation between opioid administration, pupillary changes, and patient-reported pain.
  • To assess the utility of pupillometry as an objective pain assessment tool.
  • To determine the efficacy of pupillometry in monitoring opioid effects.

Main Methods:

  • Systematic review of published literature.
  • Searched PubMed, CINAHL, Web of Science, and EMBASE databases.
  • Analyzed 14 studies meeting inclusion criteria, evaluating associations between opioids, pupillary measurements, and pain.

Main Results:

  • Opioid administration was significantly associated with pupillary constriction and altered reflexes.
  • Correlations were found between pupillary responses and reported pain levels.
  • Confounding factors like age and medications influence pupillary measurements.

Conclusions:

  • Pupillometry demonstrates promise as an objective indicator of opioid effect and pain response.
  • Interpretation requires accounting for patient-specific and clinical confounding factors.
  • Pupillary measurement can be a valuable adjunct to traditional pain assessment tools, enhancing pain evaluation and opioid safety.