Pupillary Unrest as an Indicator of Central Opioid Effect in Subjects 40-60 Years of Age

Purpose

This study will establish the relationship between magnitude of opioid exposure and a pupillary measure referred to as PUAL (pupillary unrest in ambient light), in subjects aged 40-60. Previous investigation demonstrated that loss of PUAL was a sensitive, discriminative indicator of opioid toxicity and respiratory depression among subjects aged 20-40 years old. Population data indicate that pupil size and PUAL decline slightly with age. The investigators will explore whether PUAL proves to be a sensitive indicator of opioid exposure and respiratory depression in this older group.

Conditions

  • Opioid Toxicity
  • Pupillary Miosis
  • Respiratory Depression

Eligibility

Eligible Ages
Between 40 Years and 60 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Healthy, BMI < 35 kg/m2

Exclusion Criteria

  • current or recent opioid use - opioid or other substance use disorder - known or suspected OSA or sleep disordered breathing - ischemic heart disease, heart failure or symptomatic arrhythmia history - ocular disease or previous eye surgery - active use of alpha adrenergic blockers, anticholinergic medications, - active use of antidepressant or mood stabilizing medications - active use of phosphodiesterase inhibitors - use of stimulant or appetite suppressant medications - active use of antihypertensive or antiarrhythmic medications - use of topical eye medications.

Study Design

Phase
Phase 2/Phase 3
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Diagnostic
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Remifentanil Infusion and Recovery
Participants underwent a 10-minute remifentanil infusion. Pupillary measures were taken a baseline and every 2.5 minutes during the 10-minute infusion and 25-minute recovery period.
  • Drug: Remifentanil Hydrochloride
    Infusion of 0.2 µg/k/m for 5 minutes, the 0.3 µg/k/m for 5 minutes.
  • Device: Pupillometry measurement
    Pupillary measurements were taken at baseline and every 2.5 minutes during the 10-minute infusion and 25-minute recovery period.

More Details

Status
Completed
Sponsor
University of California, San Francisco

Study Contact

Detailed Description

Healthy volunteer subjects aged 40-60 will receive a standardized weight-based 10-minute remifentanil infusion protocol to achieve a peak estimated remifentanil effect site concentration of approximately 6 ng/mL. Pupillary measures will be taken at baseline and regular time intervals during and after the infusion, over a period of 35 minutes.