![]() Patients on more than 60 morphine equivalents pr day will be included. In addition we will register all concomitant medication that also might influence pupil size and reaction. of pupils capture by sphincter pupillae Record the speed of reaction: brisk, sluggish, or fixed. On the same time we will assess pain intensity, sedation score, and other side effects of opioids while measuring the concentration of opioids and their active metabolites in blood. Learn the fundamentals of doing a basic pupil exam. In addition to pupil size measurements under standard room light conditions, two pupil size reflexes will by assessed: the pupillary light reflex when the pupil is exposed to light, and the reflex dilation during a standardized noxious stimulus. We want to perform a dynamic assessment of pupillary reflex in patients on high-dose opioids. However, cancer patients on high-dose opioids do not always present small pupil size. Also, constrictor muscle fatigability may yield. Oblique convergence often produces slip-partitioned fault systems that have different slip rakes on multiple parallel striking faults instead of a single fault with oblique slip (e As there was normal convergence amplitude and brisk pupillary constriction to a near stimulus in all 5 patients, it is not reasonable to assume that the cause of the. Pupil size and reaction are also influenced by drugs, where opioids result in miosis, an effect that is not considered to be influenced by opioid tolerance. Findings: The initially brisk pupillary constriction may become sluggish and unable to constrict maximally. Pupil size reflects the balance between sympathetic and parasympathetic systems. Why Should I Register and Submit Results?.
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