EVALUATION OF SACCADIC EYE-MOVEMENTS AS AN OBJECTIVE TEST OF RECOVERY FROM ANESTHESIA

被引:11
作者
PAUT, O
VERCHER, JL
BLIN, O
LACARELLE, B
MESTRE, D
DURAND, A
GAUTHIER, GM
CAMBOULIVES, J
机构
[1] UNIV AIX MARSEILLE 1, CONTROLES SENSORIMOTEURS LAB, CNRS, URA 1166, F-13331 MARSEILLE, FRANCE
[2] CHU TIMONE, CTR PHARMACOL CLIN & EVALUAT THERAPEUT, MARSEILLE, FRANCE
[3] CHU TIMONE, PHARMACOCINET & TOXICOL LAB, MARSEILLE, FRANCE
[4] UNIV AIX MARSEILLE 2, COGNIT & MOUVEMENT LAB, CNRS, URA 1166, MARSEILLE, FRANCE
关键词
MIDAZOLAM; PSYCHOMOTOR TESTS; RECOVERY; SACCADIC EYE MOVEMENTS;
D O I
10.1111/j.1399-6576.1995.tb04241.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Saccadic eye movements have been previously used to assess residual effect of anaesthetics, but this test is seldom compared to other psychomotor tests. The aim of the present study was to validate saccades as a recovery index in relation to frequently referred subjective and psychometric tests. Eight healthy subjects were tested before and after intra-muscular injection of either placebo or 0.15 mg . kg(-1) of midazolam. Each session consisted of a saccadic rest (recorded by electro-oculography), a choice-reaction-time test (CRT), a subjective state-of-alertness test (11 visual analogic scales) and blood sampling (to monitor midazolam plasma concentration), before and 30 (t30), 60 (t60), 120 (t120), 180 (t180), 240 (t240) minutes after drug administration In the placebo group, there was no change in subjective assessment, saccade characteristics (latency, peak velocity and duration) or CRT results. In the midazolam group, 6 subjective items changed with different time-courses, when compared to baseline: from t30 to t120 (drowsy, in shape, tired, clumsy strong) and at t120 (woolly). Saccade latency and duration were significantly different from 130 to t120 and until t180 for peak velocity. CRT performance was significantly altered From t30 to t120. Midazolam plasma concentration decreased From 177+/-33 ng . ml(-1) at t30 to 47+/-12 ng . ml(-1) at t240. At this latter time, sensorimotor functions returned to the baseline. All subjects fulfilled the clinical conditions for home discharge 4 hours after administration. These results suggest that a saccadic eye movement test is a sensitive and reliable tool for the assessment of residual effect of anaesthetics. This test was found to be more sensitive than CRT test since peak saccadic velocity was the last psychometric parameter to be returned to baseline after midazolam injection. This study also confirms the poor reliability of subjective assessment, as subjects tended to underestimate the alteration of their performance immediately following drug injection.
引用
收藏
页码:1117 / 1124
页数:8
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