Reflexo de dilatação pupilar e a mensuração da dor no paciente anestesiado: revisão de literatura

Autores

DOI:

https://doi.org/10.34024/rnc.2021.v29.12438

Palavras-chave:

sedoanalgesia, reflexo pupilar, pupilometria

Resumo

Introdução. A validação da presença de dor em pacientes sob anestesia geral permanece um desafio. A correta mensuração da sedoanalgesia pode proporcionar o uso de doses mínimas para ser atingido, evitando-se subdosagens ou superdosagens. Estudos recentes têm correlacionado a pupilometria com o nível de dor no paciente não comunicativo. Objetivos. Por meio de uma revisão bibliográfica, procuramos correlacionar a pupilometria e o reflexo de dilatação pupilar na monitorização da analgesia, no paciente sedado e não comunicativo, sob o uso de opioides e hipnóticos, bem como comparar a pupilometria com o uso de parâmetros vitais como frequência cardíaca, uso do índice de analgesia e nocicepção e o BIS. Método. Foi realizada uma revisão bibliográfica na plataforma “PubMed”, em inglês, espanhol e português, entre o período de 1996 a 2020. A busca nas bases mencionadas resultou em 38 artigos. Resultados. Verificou-se que a pupilometria apresentou dados mais confiáveis na avaliação da nocicepção quando comparada com frequência cardíaca e pressão arterial, porém ainda há dificuldade de padronização de aplicação. A pupilometria mede diversos componentes: amplitude máxima, latência, velocidade de dilatação e contração, e tamanho máximo e mínimo. Quando avaliados os sinais vitais como frequência cardíaca e pressão arterial a pupilometria tem se mostrado um melhor preditor de analgesia, tornando-se um melhor indicador para a titulação, quando utilizados remifentanil ou propofol.  Conclusões. A avaliação do reflexo de dilatação pupilar permite a mensuração da reatividade do sistema nervoso autônomo ao estímulo da dor, podendo proporcionar tratamento individualizado e com maior segurança.

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Publicado

2021-12-17

Como Citar

Brait, A. B. F., Reis, B. A., Lemos, B. D., Fernandes, I. de J., Rocha, B. A. da, & Prandini, M. N. (2021). Reflexo de dilatação pupilar e a mensuração da dor no paciente anestesiado: revisão de literatura. Revista Neurociências, 29, 1–14. https://doi.org/10.34024/rnc.2021.v29.12438

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Artigos de Revisão
Recebido em 2021-07-20
Aceito em 2021-10-27
Publicado em 2021-12-17