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Published in: Journal of Clinical Monitoring and Computing 2/2017

01-04-2017 | Original Research

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

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

Published in: Journal of Clinical Monitoring and Computing | Issue 2/2017

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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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Metadata
Title
The effects of anesthetic agents on pupillary function during general anesthesia using the automated infrared quantitative pupillometer
Authors
Kazuhiro Shirozu
Hidekazu Setoguchi
Kentaro Tokuda
Yuji Karashima
Mizuko Ikeda
Makoto Kubo
Katsuya Nakamura
Sumio Hoka
Publication date
01-04-2017
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 2/2017
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-016-9839-3

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