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Effects of general anesthesia on the human blink reflex
Author(s) -
Marelli Russell A.,
Hillel Allen D.
Publication year - 1989
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.2880110207
Subject(s) - corneal reflex , anesthesia , methohexital , reflex , anesthetic , medicine , isoflurane , propofol
The blink reflex was studied in 10 patients undergoing elective procedures under general anesthesia. Anesthetic agents were isoflurane, halothane, nitrous oxide, methohexital, and thiopental in various combinations. At induction, blink reflexes were diminished by low‐dose thiopental (1‐1.5 mg/kg) and abolished by high‐dose thiopental (4‐8 mg/kg) and methohexital (1.5 mg/ kg). Blink reflexes were absent during halogenated vo/itile inhalational anesthesia and did not return until patients were in the recovery room, well after end‐tidal anesthetic levels were zero by mass spectroscopy. Recovery of consciousness and the ability to blink on command often preceded return of any blink reflex activity, indicating that the blink reflex is not useful as a postoperative test of facial nerve function in the operating room after anesthesia. In six patients, blink reflexes were still diminished 2‐3 hours after cessation of anesthesia, at a time when patients were fully oriented and corneal and eyelid reflexes were clinically normal. This finding suggests that the blink reflex might be a sensitive test of subtle CNS dysfunction after inhalational anesthesia and potentially could serve as a useful objective indicator of recovery from anesthesia for outpatient surgery.