{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:19:44Z","timestamp":1791659984584,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T00:00:00Z","timestamp":1686441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The adequate assessment of pain in the emergency department (ED) can be challenging. Two dynamic pupillary measures used in conscious subjects after a surgical procedure were previously shown to correlate to the magnitude of ongoing pain. The objective of this study was to test the ability of dynamic measures derived from pupillometry to evaluate pain intensity in conscious adult patients admitted to the ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective, interventional, single\u2010centre study was performed between August 2021 and January 2022 (NCT05019898). An assessment of self\u2010reported pain intensity was performed on ED admission by the triage nurse using a numeric rating scale (NRS). This was followed by two dynamic measures derived from pupillometry that were previously correlated with pain perception: the pupillary unrest under ambient light (PUAL) and the pupillary light reflex (PLR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 313 analysed patients, the median age was 41\u2009years, and 52% were women. No correlation was found between self\u2010reported pain ratings and PUAL (<jats:italic>r<\/jats:italic>\u2009=\u20090.007) or PLR (baseline diameter <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.048; decrease <jats:italic>r<\/jats:italic>\u2009=\u20090.024; latency <jats:italic>r<\/jats:italic>\u2009=\u20090.019; slope\u2009=\u2009\u22120.051). Similarly, the pupillometry measures could not discriminate patients with moderate to severe pain (defined as NRS \u22654).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pupillometry does not appear to be an effective tool to evaluate pain in the ED environment. Indeed, too many factors influencing the sympathetic system\u2014and thus the dynamic pupillary measures\u2014are not controllable in the ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Pupillometry does not appear to be an effective tool to evaluate pain in the ED environment.<\/jats:p><jats:p>There are several possible explanations for these negative results. The factors influencing the sympathetic system\u2014and thus the PD fluctuations\u2014are controllable in the postoperative period but not in the ED (e.g. full bladder, hypothermia). In addition, numerous psychological phenomena can impact pupillometry measurements such as emotional reactions or cognitive tasks. These phenomena are particularly difficult to control in the ED environment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2137","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T03:33:45Z","timestamp":1686540825000},"page":"952-960","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison between pupillometry and numeric pain rating scale for pain assessments in communicating adult patients in the emergency department"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3117-9026","authenticated-orcid":false,"given":"Charles","family":"Gregoire","sequence":"first","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"},{"name":"Institute of Neuroscience (IoNS), UCLouvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Charier","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University Jean Monnet, University Hospital of Saint\u2010Etienne, INSERM  Saint\u2010Etienne France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romane","family":"de Bergeyck","sequence":"additional","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Mouraux","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience (IoNS), UCLouvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor","family":"Van\u00a0Ouytsel","sequence":"additional","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Lambert","sequence":"additional","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Zhou","sequence":"additional","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Lavand'homme","sequence":"additional","affiliation":[{"name":"Anesthesiology Department Saint\u2010Luc University Hospital, Universit\u00e9 catholique de Louvain (UCLouvain)  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Penaloza","sequence":"additional","affiliation":[{"name":"Emergency Department Cliniques Universitaires Saint\u2010Luc, Universit\u00e9 Catholique de Louvain  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisele","family":"Pickering","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department PIC\/CIC Inserm 1405\u2013University Hospital CHU  Clermont\u2010Ferrand France"},{"name":"Fundamental and Clinical Pharmacology of Pain, Faculty of Medicine Clermont Auvergne University  Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102125.1990.tb03787.x"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"E257","article-title":"Pupillometry: The influence of gender and anxiety on the pain response","volume":"16","author":"Bertrand A. 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