Validation of Pupillary Response to Nociceptive Stimulation in Cardiac Surgery During Extracorporeal Circulation Period

Inclusion Criteria: * general anesthesia for cardiac surgery programmed requiring the realization of a sternotomy and the use of extra corporeal circulation * age\> 18 years Exclusion Criteria: * contraindication to the use of the products defined in the protocol of anesthesia (alprazolam, remifentanil, propofol, atracurium) * sedation in progress with use of morphinomimetics * urgent surgery * preoperative existence of circulatory assistance * preoperative existence of an intra-aortic balloon pump, * bilateral ocular pathology (severe cataract, amblyopia, glaucoma, keratitis, conjunctivitis) and / or history of bilateral ocular surgery affecting the iris * history of epilepsy, cerebral palsy * peripheral neuromuscular diseases * pathology with dysautonomia impairing the pupillary dilation reflex: insulin-dependent type 1 or type 2 diabetes with diabetic retinopathy, multiple sclerosis, systemic amyloidosis, uncontrolled hypertension, advanced Parkinson's disease * ongoing treatment interfering with the autonomic and central nervous system likely to alter the pupillary dilation reflex: antiemetic (droperidol, metoclopramide), alpha-2 agonist (clonidine, dexmedetomidine), high doses of nitrous oxide * treatment with severe anticholinergic effect: such as amitriptyline, amoxapine, atropine, benztropine, chlorpheniramine, chlorpromazine, clemastine, clomipramine, clozapine, darifenacin, desipramine, dicyclomine, diphenhydramine, doxepin, flavoxate, hydroxyzine, hyoscyamine, i…