title: Neuromuscular blocking drugs do not alter the pupillary light reflex of anesthetized humans.
abstract: OBJECTIVE
  To test the hypothesis that systemically administered neuromuscular blocking drugs acutely alter resting pupil size or the direct reflex response to light in anesthetized humans.
  
  
  METHODS
  Patients were randomized to receive an intravenous injection of saline (0.15 mL/kg), pancuronium bromide (0.1 mg/kg), or vecuronium bromide (0.15 mg/kg) after induction of general anesthesia and tracheal intubation.
  
  
  METHODS
  The University of California, San Francisco, Moffitt-Long Hospitals.
  
  
  METHODS
  Healthy adults (American Society of Anesthesiologists physical status I or II) of either sex scheduled for elective surgery requiring general anesthesia, tracheal intubation, and muscle relaxation of an anticipated duration of 2 or more hours.
  
  
  METHODS
  Measurements of resting pupil size, direct reflex response to light, and constriction velocity were obtained in double-blinded fashion using infrared pupillometry.
  
  
  RESULTS
  Pupillary size, reflex amplitude, and constriction velocity were not altered by the presence of either vecuronium or pancuronium. Tetanic stimuli and concomitant isoflurane administration respectively increased and decreased pupillary light reflex amplitude, indicating that pupillary responses were not fixed.
  
  
  CONCLUSIONS
  We conclude that systemically administered neuromuscular blocking drugs (vecuronium and pancuronium) do not acutely affect the pupillary light reflex in healthy, anesthetized patients.
authors.affiliation: Department of Anesthesia, San Francisco General Hospital, Calif, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Gray
authors.forename: S T
authors.initials: ST
authors.lastname: Krejci
authors.forename: M D
authors.initials: MD
authors.lastname: Larson
mesh_terms: D000328:Adult; D000758:Anesthesia; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D010197:Pancuronium / Q000494:pharmacology; D011680:Pupil / Q000187:drug effects* / Q000528:radiation effects*; D014673:Vecuronium Bromide / Q000494:pharmacology
chemical_list: D009466:Neuromuscular Blocking Agents; D014673:Vecuronium Bromide; D010197:Pancuronium