British journal of anaesthesia
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Estimation of analgesia in anaesthetized children is often imprecise, and consequently, anaesthesiologists commonly evaluate children's response to surgical stimulation by movement or haemodynamic changes. In adults reflex pupillary dilatation has been demonstrated to be a very sensitive measure of noxious stimulation, correlated with opioid concentrations. The autonomic nervous control changes with age, raising the hypothesis that mechanisms involved in pupillary autonomic functions regarding both sympathetic and parasympathetic components may also differ between adults and children. In this pilot study, we tested the hypothesis that the pupillary reflex dilatation might allow assessment of noxious stimulation and analgesic effect of alfentanil in children under sevoflurane anaesthesia, as an alternative to haemodynamic and bispectral measures. ⋯ PD is a more sensitive measure of noxious stimulation than the commonly used variables of heart rate, arterial blood pressure and BIS in children anaesthetized with sevoflurane.
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beta-Adrenergic blocking agents may interact with anaesthetics, and several studies suggest that beta-blockers attenuate electroencephalographic responses during general anaesthesia. We have investigated the influence of landiolol, an ultra-short-acting beta 1-adrenoceptor antagonist, on the electroencephalographic effect of isoflurane in pigs. ⋯ Landiolol does not alter the electroencephalographic effect of isoflurane.