External ophthalmoplegia after total intravenous anaesthesia.
Eye-opening and eye movements were assessed in 110 awake and cooperative ASA class 1 and 2 patients after elective ENT surgery with total intravenous anaesthesia using propofol, fentanyl and atracurium. Following tracheal extubation and after regaining consciousness 21 patients showed a complete transient bilateral inability to open their eyes combined with a total gaze paresis, while another 30 patients showed an impairment of eye-opening and/or eye movements to a lesser extent. In all patients affected symmetrical recovery of both impaired eye-opening and eye movements occurred during the following 20 min. The occurrence of ophthalmological symptoms was not related to the duration of anaesthesia or the propofol infusion rate. Thus a complex ophthalmological phenomenon occurred after total intravenous anaesthesia in approximately 50% of awake and cooperative patients. The aetiology of this phenomenon and the implications for the understanding of the mechanisms of general anaesthesia remain to be determined.
Department of Anaesthesia, Kantonsspital, Basel, Switzerland.
S C
SC
Marsch
H G
HG
Schaefer
D000328:Adult; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000009:adverse effects*; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D009886:Ophthalmoplegia / Q000139:chemically induced*; D011183:Postoperative Complications / Q000139:chemically induced*; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D013997:Time Factors
D015742:Propofol