Anisocoria during isoflurane anaesthesia in a six‐year‐old girl

Kuhn, Iris; Wissing, H.

doi:10.1046/j.1460-9592.1996.d01-4.x

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…Cocaine can cause anisocoria by inhibiting noradrenaline re-uptake and affecting only the sympathetic nervous system (9). Kuhn et al detected dilatation in the right pupil diameter 30 minutes after the application of 2% concentration of isoflurane they used during induction in a girl they operated due to hiatal hernia (10). Similarly, in a case report reported by Akhlaghi, unilateral anisocoria occurring 30 minutes after the use of pofol, an anesthesia induction agent was reported in a patient undergoing surgery for an open extremity fracture (11).…”

Section: Discussionmentioning

confidence: 91%

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Akça¹,

İslam²,

Akgün³

et al. 2021

J Exp Clin Med

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This prospective randomized study aimed to compare the effects of nebulizer drugs on unilateral or bilateral dilation of the pupil that may develop due to mask incompatibility or patient incompatibility in patients receiving inhaled therapy. Following the approval of the local ethics committee, this study was carried out prospectively and observationally in the period from October 1, 2018 to April 1, 2019 in an emergency clinic with an annual capacity of 600,000 patients in a tertiary education and research hospital. The patients were divided into three groups: those given salbutamol alone (200 mcg), those given ipratropium alone (250 mcg/2ml), and those receiving both salbutamol and ipratropium. The pupil diameters of the patients included in the study were measured twice using a pupilometer device at hours 0 and 2 of treatment. Ninety- one patients that received inhaler treatment in the emergency department were included in the study. The process of treatments given to patients with indications was not interrupted. Ipratropium and salbutamol (49.5%) were used together in 45 patients, ipratropium alone in 38 (41.7%), and salbutamol alone in eight (8.8%). When the absolute delta ratios were compared, a statistically significant difference was observed between the patients given salbutamol and those given ipratropium, and between the patients that received salbutamol and those given salbutamol and ipratropium (p=0.001, 95% CI: 1.36-6.11 and p<0.001, 95% CI: 1.51- 6.19, respectively). Salbutamol caused statistically significantly greater pupil diameter changes than the other drugs. Although neurological diagnoses are considered in patients with anisocoria, it should be kept in mind that anisocoria may also be due to the current or the treatment being given.

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Section: Discussionmentioning

confidence: 91%

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Akça¹,

İslam²,

Akgün³

et al. 2021

J Exp Clin Med

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“…Much less is known about dyskinesia, anisocoria, low or irregular heart rate, and confusion. Descriptions of these other atypical presentations were included in three anesthesia case reports with dyskinesia [11–13] and three that documented anisocoria [14–16]. For example, a case study of a 26-year-old man who was administered fentanyl anesthesia for surgery exhibited similar characteristics as overdose cases from Insite featuring dyskinesia [11].…”

Section: Introductionmentioning

confidence: 99%

Rigidity, dyskinesia and other atypical overdose presentations observed at a supervised injection site, Vancouver, Canada

2018

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ObjectiveIn midst of the overdose crisis, the clinical features of opioid overdoses seem to be changing. Understanding of the adverse effects of synthetic opioids such as fentanyl is currently limited to clinical settings. Insite, a supervised injection site in Vancouver, Canada, provides an opportunity to better understand illicit drug overdose presentations.MethodsA review of clinical records at Insite for October 2016 to April 2017 was undertaken to quantify atypical overdose presentations. Overdose reports were reviewed for the number of atypical opioid overdose presentations, temporal trends over the study period, concurrent symptoms, and interventions employed by staff.ResultsInsite staff responded to 1581 overdoses during the study period, including 497 (31.4%) that did not fit a typical presentation for opioid overdoses. Of these, 485 fit into five categories of atypical features: muscle rigidity, dyskinesia, slow or irregular heart rate, confusion, and anisocoria. Muscle rigidity was the most common atypical presentation, observed in 240 (15.2%) of the overdose cases, followed by dyskinesia, observed in 150 (9.2%). Slow or irregular heart rate was observed in 69 (4.4%) cases, confusion in 24 (1.5%), and anisocoria in 2 (0.1%) of overall overdose cases.DiscussionThe similarity of atypical overdose cases at Insite with anesthesiology case reports supports the understanding that the illicit drug supply is contaminated by fentanyl and other synthetic opioids. Atypical overdose presentations can affect clinical overdose response. The experience at Insite highlights the potential for supervised consumption sites to be innovative spaces for community learning and knowledge translation.

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Abbruch der Anästhesie bei neu aufgetretener Anisokorie mit fehlenden Lichtreflexen

et al. 2012

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Anisocoria during general anaesthesia is rare. The combination of anisocoria and absence of any reaction to light is highly suspicious of an intracerebral lesion. This article reports the case of a patient with known Adie's syndrome where anisocoria led to an unnecessary immediate interruption of anesthesia. A preoperative examination, including inspection of the pupils, frequent perioperative check ups and documentation of diagnostic findings, even if negative, has to be standard for every anesthesia.

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Anisocoria during isoflurane anaesthesia in a six‐year‐old girl

Abstract: A case report of transient anisocoria during routine anaesthesia in a six‐year‐old female, where isoflurane was suspected of causing unilateral mydriasis.

Cited by 8 publications

References 4 publications

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Relationship of inhaled ipratropium and inhaled salbutamol with pupil dilation: A prospective observational study

Rigidity, dyskinesia and other atypical overdose presentations observed at a supervised injection site, Vancouver, Canada

Abbruch der Anästhesie bei neu aufgetretener Anisokorie mit fehlenden Lichtreflexen

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