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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
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Changes in Quantitative Pupillometry After General Anesthesia and Neuromuscular Blockade.
Siddharth Dave1, Chahat Rana2, Jade L Marshall3
1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX.
Summary
General anesthesia with neuromuscular blockade significantly slows pupillary velocity and reactivity. Quantitative pupillometry (QP) revealed reduced Neurological Pupil Index and altered constriction/dilation speeds, indicating changes in autonomic function.
Area of Science:
- Anesthesiology
- Ophthalmology
- Neuroscience
Background:
- Quantitative pupillometry (QP) offers standardized pupillary assessment.
- QP may aid in monitoring patients under general anesthesia with neuromuscular blockade.
Purpose of the Study:
- To investigate the impact of general anesthesia with neuromuscular blockade on quantitative pupillometry (QP) values.
- To explore changes in pupillary assessment metrics during surgical procedures.
Main Methods:
- Prospective observational study involving adult surgical patients.
- Handheld pupillometer used for QP readings before and after anesthesia induction.
- Readings taken every 5 minutes up to 20 minutes or procedure start.
Main Results:
- General anesthesia induction significantly reduced Neurological Pupil Index, constriction velocity, dilation velocity, and percent change in pupil size.
- Latency of constriction and pupil size after light exposure significantly increased.
- No significant change in Neurological Pupil Index was observed after rocuronium or succinylcholine administration.
Conclusions:
- General anesthesia with neuromuscular blockade (rocuronium or succinylcholine) leads to decreased pupillary velocity and reactivity.
- Further research is needed to fully understand the implications of these QP metric changes.
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