Latency of pupillary reflex dilation during general anesthesia

Journal of Applied Physiology
Merlin D LarsonD I Sessler

Abstract

Areas of insensibility produced by neuraxial anesthesia or peripheral nerve blocks can be detected during general anesthesia by failure of noxious stimulation to trigger pupillary reflex dilation. We examined the latency of pupillary reflex dilation and the effect of fentanyl on the latency of reflex dilation during anesthesia in nine volunteers. We hypothesized that the reflex was generated by slowly conducting C nociceptive fibers and would be significantly delayed if a distal dermatome (L(4)) was stimulated compared with a proximal dermatome (C(5)). We also hypothesized that fentanyl would prolong the latency and alter the shape of the reflex. After induction of general anesthesia, pupillary reflex dilation was measured with an infrared pupillometer every 5 min after stimulations of the L(4) and C(5) dermatomes. Fentanyl (3 microg/kg) was then given intravenously. Pupillary reflex dilation latencies were calculated by examining each individual measurement. After 3 h, naloxone (400 microg) was given intravenously; anesthesia was then discontinued. Pupillary reflex dilation had a long latency and consisted of distinct early and late phases. No differences were found between latencies of reflex dilation after simulation of L(4)...Continue Reading

References

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Citations

Jan 11, 2007·British Journal of Anaesthesia·M D LarsonD I Sessler
Jun 12, 2012·Annales Françaises D'anesthèsie Et De Rèanimation·J-F PayenG Francony
Apr 10, 2008·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Merlin D Larson
Apr 26, 2006·Best Practice & Research. Clinical Anaesthesiology·Bruno Guignard
Sep 12, 2017·Journal of the Chinese Medical Association : JCMA·Mansoor MasjediMahnaz Rakhshan
Mar 22, 2012·Anesthesiology·Merlin D Larson, Daniel I Sessler

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