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Abstract
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Background and Aims Exploring neurobiological pain markers is crucial for tailored therapies. Non-invasive methods like EEG, pupillometry, and NOL provide nociception-related perioperative insights. This study examines their correlation with post-thoracic surgery pain, focusing on preoperative alpha EEG oscillations (Peak Alpha Frequency, PAF), pupillometry, and NOL’s predictive potential.
Methods Patients over 18 undergoing major thoracic surgery participated in this study. Pupillometry using the NPi-200 pupillometer assessed parameters like contraction velocity (CV), maximum contraction velocity (MCV), contraction percentage change (CH%) and dilation velocity (DV). Ambient light was measured with a commercial luxmeter. Scalp EEG was collected preoperatively using a 7-electrode EEGrid-headset. Data were processed using EEGLAB and FieldTrip, including preprocessing, frequency decomposition, and estimation of sensorimotor PAF. NOL data from the PMD-200 system were analyzed. General anesthesia was standardized, and opioid doses were calculated. Pain was assessed using an 11-point NRS at PACU, DN4 questionnaire, and NRS scale at one- and three-months post-surgery.
Results Data from 19 participants (10 males, mean age 68.05) demonstrated strong correlations between PACU pupillometry parameters and DN4 scores at one- and three-months post-surgery. Additionally, NRS scores at one and three months were significantly correlated with PACU pupillometry indices (table 1). Conversely, no significant associations were found between NOL or EEG data and pain outcomes.
correlations between pupillometry parameters and chronic and neuropathic pain at one and three months post-surgery
Conclusions Immediate postoperative pupillometry strongly correlates with chronic and neuropathic pain at one- and three-months post-thoracotomy, suggesting its predictive potential for long-term outcomes. However, preoperative PAF and intraoperative NOL did not correlate with postoperative pain, emphasizing pupillometry’s utility in personalized pain perception and management, warranting further validation with larger cohorts.