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dc.contributor.authorIohom, G
dc.contributor.authorGardiner, C
dc.contributor.authorWhyte, A
dc.contributor.authorO'Connor, G
dc.contributor.authorShorten, G
dc.date.accessioned2012-02-03T15:08:04Z
dc.date.available2012-02-03T15:08:04Z
dc.date.issued2012-02-03T15:08:04Z
dc.identifier.citationEur J Anaesthesiol. 2004 Aug;21(8):646-52.en_GB
dc.identifier.issn0265-0215 (Print)en_GB
dc.identifier.issn0265-0215 (Linking)en_GB
dc.identifier.pmid15473620en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208943
dc.description.abstractBACKGROUND AND OBJECTIVE: We tested the hypothesis that disturbances of the visual pathway following sevoflurane general anaesthesia (a) exist and persist even after clinical discharge criteria have been met and (b) are associated with decreased contrast sensitivity. METHODS: We performed pattern and full-field flash electroretinograms (ERG) in 10 unpremedicated ASA I patients who underwent nitrous oxide/sevoflurane anaesthesia. ERG and contrast sensitivity were recorded preoperatively, immediately after discharge from the recovery room and 2 h after discontinuation of sevoflurane. The time at which the Post Anaesthesia Discharge Score first exceeded 9 was also noted. Data were analysed using paired, one-tailed t-tests and Pearson's correlation coefficient. RESULTS: On the full-field photopic ERG, b-wave latency was greater at each postoperative time point (31.6+/-1.1 and 30.8+/-1.1 ms) compared to preoperatively (30.1+/-1.1 ms, P < 0.001 and P = 0.03, respectively). Oscillatory potential latencies were greater on discharge from the recovery room compared with preanaesthetic values (23.1+/-3.1 vs. 22.4+/-3.3 ms, P = 0.01) and returned to baseline by 2 h after emergence from anaesthesia. Also at 2 h after emergence from anaesthesia: (a) P50 latency on the pattern ERG was greater than at baseline (81.5+/-17.9 vs. 51.15+/-22.6ms, P = 0.004); (b) N95 amplitude was less compared to preanaesthetic values (2.6+/-0.5 vs. 3.3+/-0.4 microV, P = 0.003) and (c) contrast sensitivity was less compared to baseline values (349+/-153 vs. 404+/-140, P = 0.048). A positive correlation was demonstrated between contrast sensitivity and both N95 amplitude and b-wave latency (r = 0.99 and r = -0.55 at significance levels of P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Postoperative ERG abnormalities and associated decreases in contrast sensitivity are consistently present in patients who have undergone nitrous oxide/sevoflurane anaesthesia. These abnormalities persist beyond the time at which standard clinical discharge criteria have been met.
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnesthetics, Inhalation/*adverse effectsen_GB
dc.subject.meshColor Perception/drug effectsen_GB
dc.subject.meshContrast Sensitivity/*drug effectsen_GB
dc.subject.meshElectroretinography/*drug effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMethyl Ethers/*adverse effectsen_GB
dc.subject.meshNitrous Oxideen_GB
dc.subject.meshOrthopedic Proceduresen_GB
dc.subject.meshPostoperative Perioden_GB
dc.subject.meshVision Testsen_GB
dc.subject.meshVisual Acuity/drug effectsen_GB
dc.titleAbnormalities of contrast sensitivity and electroretinogram following sevoflurane anaesthesia.en_GB
dc.contributor.departmentCork University Hospital and University College Cork, Department of Anaesthesia, and Intensive Care Medicine, Cork, Ireland.en_GB
dc.identifier.journalEuropean journal of anaesthesiologyen_GB
dc.description.provinceMunster
html.description.abstractBACKGROUND AND OBJECTIVE: We tested the hypothesis that disturbances of the visual pathway following sevoflurane general anaesthesia (a) exist and persist even after clinical discharge criteria have been met and (b) are associated with decreased contrast sensitivity. METHODS: We performed pattern and full-field flash electroretinograms (ERG) in 10 unpremedicated ASA I patients who underwent nitrous oxide/sevoflurane anaesthesia. ERG and contrast sensitivity were recorded preoperatively, immediately after discharge from the recovery room and 2 h after discontinuation of sevoflurane. The time at which the Post Anaesthesia Discharge Score first exceeded 9 was also noted. Data were analysed using paired, one-tailed t-tests and Pearson's correlation coefficient. RESULTS: On the full-field photopic ERG, b-wave latency was greater at each postoperative time point (31.6+/-1.1 and 30.8+/-1.1 ms) compared to preoperatively (30.1+/-1.1 ms, P < 0.001 and P = 0.03, respectively). Oscillatory potential latencies were greater on discharge from the recovery room compared with preanaesthetic values (23.1+/-3.1 vs. 22.4+/-3.3 ms, P = 0.01) and returned to baseline by 2 h after emergence from anaesthesia. Also at 2 h after emergence from anaesthesia: (a) P50 latency on the pattern ERG was greater than at baseline (81.5+/-17.9 vs. 51.15+/-22.6ms, P = 0.004); (b) N95 amplitude was less compared to preanaesthetic values (2.6+/-0.5 vs. 3.3+/-0.4 microV, P = 0.003) and (c) contrast sensitivity was less compared to baseline values (349+/-153 vs. 404+/-140, P = 0.048). A positive correlation was demonstrated between contrast sensitivity and both N95 amplitude and b-wave latency (r = 0.99 and r = -0.55 at significance levels of P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Postoperative ERG abnormalities and associated decreases in contrast sensitivity are consistently present in patients who have undergone nitrous oxide/sevoflurane anaesthesia. These abnormalities persist beyond the time at which standard clinical discharge criteria have been met.


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