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The effects of anesthetic agents on pupillary function during general anesthesia using the automated infrared quantitative pupillometer.
Shirozu, Kazuhiro; Setoguchi, Hidekazu; Tokuda, Kentaro; Karashima, Yuji; Ikeda, Mizuko; Kubo, Makoto; Nakamura, Katsuya; Hoka, Sumio.
Afiliación
  • Shirozu K; Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. shiron@kuaccm.med.kyushu-u.ac.jp.
  • Setoguchi H; Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Tokuda K; Intensive Care Unit, Kyushu University Hospital, Fukuoka, Japan.
  • Karashima Y; Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
  • Ikeda M; Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
  • Kubo M; Department of Surgery and Oncology, Kyushu University Hospital, Fukuoka, Japan.
  • Nakamura K; Department of Surgery and Oncology, Kyushu University Hospital, Fukuoka, Japan.
  • Hoka S; Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
J Clin Monit Comput ; 31(2): 291-296, 2017 Apr.
Article en En | MEDLINE | ID: mdl-26858211
Pupil reactivity can be used to evaluate central nervous system function and can be measured using a quantitative pupillometer. However, whether anesthetic agents affect the accuracy of the technique remains unclear. We examined the effects of anesthetic agents on pupillary reactivity. Thirty-five patients scheduled for breast or thyroid surgery were enrolled in the study. Patients were divided into four groups based on the technique used to maintain anesthesia: a sevoflurane-remifentanil (SEV/REM) group, a sevoflurane (SEV) group, a desflurane-remifentanil (DES/REM) group, and a propofol-remifentanil (PRO/REM) group. We measured maximum resting pupil size (MAX), reduction pupil size ratio (%CH), latency duration (LAT) and neurological pupil index (NPi). A marked reduction in MAX and %CH compared with baseline was observed in all groups, but LAT was unchanged during surgery. NPi reduced within the first hour of surgery in the SEV/REM, SEV, and DES/REM groups, but was not significantly different in the PRO/REM group. Compared with the PRO/REM group, mean %CH and NPi in patients anesthetized with SEV/REM, SEV or DES/REM were markedly lower at 1 h after surgery had commenced. There was no correlation between NPi and bispectral index. Fentanyl given alone decreased pupil size and %CH in light reflex, but did not change the NPi. NPi was decreased by inhalational anesthesia not but intravenous anesthesia. The difference in pupil reactivity between inhalational anesthetic and propofol may indicate differences in the alteration of midbrain reflexs in patients under inhalational or intravenous anesthesia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espectrofotometría Infrarroja / Procesamiento de Señales Asistido por Computador / Pupila / Anestésicos Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Clin Monit Comput Asunto de la revista: INFORMATICA MEDICA / MEDICINA Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Espectrofotometría Infrarroja / Procesamiento de Señales Asistido por Computador / Pupila / Anestésicos Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Clin Monit Comput Asunto de la revista: INFORMATICA MEDICA / MEDICINA Año: 2017 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos