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논문 기본 정보

자료유형
학술저널
저자정보
Kim Eugene (Department of Anesthesiology and Pain Medicine Hanyang University Medical Center Hanyang University College of Medicine) 임정아 (대구가톨릭대학교) 최창혁 (대구가톨릭대학교) Lee So Young (Department of Anesthesiology and Pain Medicine Daegu Catholic University School of Medicine) Kwak Seongmi (Department of Anesthesiology and Pain Medicine Daegu Catholic University Medical Center Daegu Catholic University School of Medicine) 김종해 (대구가톨릭대학교)
저널정보
대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.76 No.2
발행연도
2023.4
수록면
116 - 127 (12page)
DOI
10.4097/kja.22324

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Background: As a side effect of interscalene brachial plexus block (ISBPB), stellate ganglion block (SGB) causes reductions in pupil size (Horner’s syndrome) and cardiac sympathetic nervous activity (CSNA). Reduced CSNA is associated with hemodynamic instability when patients are seated. Therefore, instantaneous measurements of CSNA are important in seated patients presenting with Horner’s syndrome. However, there are no effective tools to measure real-time CSNA intraoperatively. To evaluate the usefulness of pupillometry in measuring CSNA, we investigated the relationship between pupil size and CSNA.Methods: Forty-two patients undergoing right arthroscopic shoulder surgery under ISBPB were analyzed. Pupil diameters were measured at 30 Hz for 2 s using a portable pupillometer. Bilateral pupil diameters and CSNA (natural-log-transformed low-frequency power [0.04–0.15 Hz] of heart rate variability [lnLF]) were measured before ISBPB (pre-ISBPB) and 15 min after transition to the sitting position following ISBPB (post-sitting). Changes in the pupil diameter ([right pupil diameter for post-sitting – left pupil diameter for post-sitting] – [right pupil diameter for pre-ISBPB – left pupil diameter for pre-ISBPB]) and CSNA (lnLF for post-sitting – lnLF for pre-ISBPB) were calculated.Results: Forty-one patients (97.6%) developed Horner’s syndrome. Right pupil diameter and lnLF significantly decreased upon transition to sitting after ISBPB. In the linear regression model (R2 =0.242, P=0.001), a one-unit decrease (1 mm) in the extent of changes in the pupil diameter reduced the extent of changes in lnLF by 0.659 ln(ms2/Hz) (95% CI [0.090, 1.228]).Conclusions: Pupillometry is a useful tool to measure changes in CSNA after the transition to sitting following ISBPB.

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