• A&A practice · May 2018

    Pupillary Unrest in Ambient Light and Prediction of Opioid Responsiveness: Case Report on Its Utility in the Management of 2 Patients With Challenging Acute Pain Conditions.

    • Rachel Eshima McKay, Andrew E Neice, and Merlin D Larson.
    • From the Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California.
    • A A Pract. 2018 May 15; 10 (10): 279-282.

    AbstractPupillary unrest in ambient light (PUAL), the normal pattern of pupil diameter fluctuation present in awake humans, has been proposed as a marker of central opioid effect. We report 2 cases in which PUAL identified the appropriate pain management for 2 patients, each with unique, challenging acute pain conditions. In both cases, PUAL accurately predicted opioid responsiveness, suggesting an effective, individualized analgesic approach for both patients.

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