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Postoperative changes in the full-field electroretinogram following sevoflurane anaesthesia

Published online by Cambridge University Press:  23 December 2004

G. Iohom ,
A. Whyte ,
T. Flynn ,
G. O'Connor  and
G. Shorten
G. Iohom
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
A. Whyte
Affiliation:
Cork University Hospital, Department of Ophthalmology, Cork, Ireland
T. Flynn
Affiliation:
Cork University Hospital, Department of Ophthalmology, Cork, Ireland
G. O'Connor
Affiliation:
Cork University Hospital, Department of Ophthalmology, Cork, Ireland
G. Shorten
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
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Extract

Summary

Background and objective: We tested the hypothesis that disturbances of the visual pathway persist following general anaesthesia, even after normal clinical discharge criteria have been met.

Methods: We performed full-field flash electroretinography in the right eye of 10 unpremedicated ASA I patients who underwent N2O/sevoflurane anaesthesia. Electroretinograms were recorded preoperatively, immediately after discharge from the recovery room and 2 h after discontinuation of sevoflurane. The time at which postanaesthesia discharge score first exceeded 9 was also noted. Data were analysed using paired, one-tailed Student's t-test.

Results: Latency of the b-wave on the photopic electroretinogram was greater at each postoperative time point (30.5 ± 0.9 and 30 ± 1.3 ms), compared to preoperative values (29.2 ± 0.8 ms, P < 0.001 and P = 0.04, respectively). The A–B amplitude of the b-wave was less postoperatively (220.3 ± 52.7 and 210.3 ± 42.7 μV) compared to values before operation (248.1 ± 57.6 μV, P = 0.03 and P = 0.01, respectively). Oscillatory potential latencies were greater at each postoperative time point (21.4 ± 0.5 and 20.8 ± 0.6 ms) compared to before operation (20.4 ± 0.4 ms, P < 0.001 and P = 0.03, respectively). Oscillatory potential amplitudes were less at the first postoperative time point (17.5 ± 6.1 μV), compared to preoperative values (22 ± 6.4 μV, P = 0.04).

Conclusions: Postoperative electroretinogram abnormalities are consistently present in patients who have undergone N2O/sevoflurane anaesthesia. These abnormalities persist beyond the time at which standard clinical discharge criteria have been met.

Keywords

ANAESTHESIAANAESTHETICS INHALATIONAL, sevoflurane, nitrous oxideANAESTHESIA RECOVERY PERIODDIAGNOSTIC TECHNIQUES, ophthalmological, electroretinography
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 272 - 278
Copyright
2004 European Society of Anaesthesiology

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