The effects of anesthetic agents on pupillary function during general anesthesia using the automated infrared quantitative pupillometer

Kazuhiro Shirozu, Hidekazu Setoguchi, Kentaro Tokuda, Yuji Karashima, Mizuko Ikeda, Makoto Kubo, Katsuya Nakamura, Sumio Hoka

研究成果: ジャーナルへの寄稿記事

9 引用 (Scopus)

抄録

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.

元の言語英語
ページ(範囲)291-296
ページ数6
ジャーナルJournal of Clinical Monitoring and Computing
31
発行部数2
DOI
出版物ステータス出版済み - 4 1 2017

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Pupil
General Anesthesia
Anesthetics
Intravenous Anesthesia
Anesthesia
Fentanyl
Propofol
Mesencephalon
Reflex
Thyroid Gland
Breast
Central Nervous System
Light

All Science Journal Classification (ASJC) codes

  • Health Informatics
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

これを引用

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abstract = "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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AU - Shirozu, Kazuhiro

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AU - Karashima, Yuji

AU - Ikeda, Mizuko

AU - Kubo, Makoto

AU - Nakamura, Katsuya

AU - Hoka, Sumio

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